Abstract
Introduction and hypothesis
Sling surgery is common for stress urinary incontinence (SUI). Yet many women have stress-predominant mixed urinary incontinence (MUI). The change in urgency/urge urinary incontinence (U/UUI) following treatment is not well documented. Our aim was to assess changes in U/UUI in women undergoing a sling placement for MUI and correlate this with improvement in quality of life (QOL).
Methods
This was a retrospective review of women treated for SUI with either an autologous rectus fascia pubovaginal sling (AF-PVS) or synthetic retropubic midurethral sling (MUS). Validated questionnaires—Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire–Short Form (IIQ-7), and visual analog scale (VAS) were obtained pre- and postoperatively. The independent association between change in storage symptoms and subjective cure—as defined by improved overall score on UDI-6, VAS score ≥ 7, or both —were assessed using multivariate logistic regression.
Results
Nine hundred and twenty-seven women were identified for inclusion; 718 (77.5 %) had preoperative MUI, of whom 487 (67.8 %) received an MUS and 231 (32.2 %) an AF-PVS. Similar objective cure rates were noted following MUS vs. AF-PVS (78.2 % vs. 71.9 %, p = 0.315). Subjectively, women treated with MUS experienced greater improvement in U/UUI (72.8 % vs. 57.6 %, p = <0.001) than AF-PVS. Multivariate analysis showed MUS patients were more than twice as likely to show subjective improvement in UDI-6 and VAS scores than the AF-PVS cohort. Postoperatively, validated questionnaires were significantly associated with storage symptom outcome.
Conclusions
Patients with U/UUI experience significant symptom improvement following treatment for MUI. QoL assessment following surgery is directly correlated with improvement in U/UUI.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hunskaar S, Burgio K, Diokno A (2003) Epidemiology and natural history of urinary incontinence in women. Urol 62(4):16–23
Kocak I, Okyay P, Dundar M, Erol H, Beser E (2005) Female Urinary Incontinence in the West of Turkey: Prevalence, Risk Factors and Impact on Quality of Life. Eur Urol 48(4):634–641
Sensoy N, Dogan N, Ozek B, Karaaslan L (2013) Urinary incontinence in women: prevalence rates, risk factors and impact on quality of life. Pakistan J Med Sci 29(3):818–822
Padmanabhan P, Dmochowski R (2014) Urinary incontinence in women: a comprehensive review of the pathophysiology, diagnosis and treatment. Minerva Ginecol 66(5):469–478
Wu JM, Gandhi MP, Shah AD (2011) Trends in inpatient urinary incontinence surgery in the USA, 1998–2007. Int Urogyn J 22(11):1437–1443
Bandukwala NQ, Gousse AE (2015) Mixed urinary incontinence: what first? Curr UrolRep 16(3):9
Palva K, Gustaf Nilsson C (2011) Prevalence of urgency symptoms decreases by mid-urethral sling procedures for stress urinary incontinence. Int Urogynecol J 22(10):1241–1247
Sirls LT, Tennstedt S, Albo M et al (2010) Factors associated with quality of life in women undergoing surgery for stress urinary incontinence. J Urol 184:2411–2415
McGuire EJ, Lytton B (1978) Pubovaginal sling procedures for stress incontinence. J Urol 119(1):82–84
Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 7(2):81–85, discussion 85–6
Rodriguez LV, Raz S (2003) Prospective analysis of patients treated with a distal urethral polypropylene sling for symptoms of stress urinary incontinence: surgical outcome and satisfaction determined by patient driven questionnaires. J Urol 170(3):857–863
Padmanabhan P, Nitti VW (2006) Female stress urinary incontinence: how do patient and physician perspectives correlate in assessment of outcomes? Curr Opin Urol 16(4):212–218
Kobashi KC, Govier F (2005) The completely dry rate: a critical re-evaluation of the outcomes of slings. Neurourol Urodyn 24(7):602–605
Lee J-S, Dwyer P, Rosamilia A, Lim Y, Polyakov A, Stav K (2011) Persistence of urgency and urge urinary incontinence in women with mixed urinary symptoms after midurethral slings: a multivariate analysis. BJOG: Int J Obstet Gynaecol 118:798–805
Maldonado PA, Kogutt BK, Wai CY (2014) Patient satisfaction following midurethral sling surgeries. Curr Opin Obstet Gynecol 26(5):404–408
Clifton MM, Linder BJ, Lightner DJ (2014) Risk of repeat anti-incontinence surgery following sling release: a review of 93 cases. J Urol 191(3):710–714
Milose JC, Sharp KM, and He C (2014) Success of autologous fascia following failed synthetic midurethral sling. J Urol
Minassian VA, Devore E, Hagan K, Grodstein F (2013) Severity of urinary incontinence and effect on quality of life in women by incontinence type. Obstet Gynecol 121(5):1083–1090
Mallah F, Montazeri A, Ghanbari Z, Tavoli A, Haghollahi F, Aziminekoo E (2014) Effect of Urinary Incontinence on Quality of Life among Iranian Women. J Family Reprod Health 8(1):13–19
Gleason JL, Parden AM, Jauk V, Ballard A, Sung V, Richter HE (2015) Outcomes of midurethral sling procedures in women with mixed urinary incontinence. Int Urogynecol J 26(5):715–720
Palva K, Nilsson CG (2011) Prevalence of urinary urgency symptoms decreases by mid-urethral sling procedures for treatment of stress incontinence. Int Urogynecol J 22(10):1241–1247
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
None
Conflict of interest
None
Additional information
Presentation: Podium, PD28-11, American Urologic Association Annual Meeting 2015, New Orleans, LA, Sunday, 17 May 2015, 1:00 p.m.—3:00 p.m.
Rights and permissions
About this article
Cite this article
Padmanabhan, P., Panfili, Z., Parker, W. et al. Change in urinary storage symptoms following treatment for female stress urinary incontinence. Int Urogynecol J 27, 1169–1174 (2016). https://doi.org/10.1007/s00192-016-2951-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-016-2951-6