Abstract
This study investigated changes in condition-specific quality of life (QOL) after surgery for stress urinary incontinence. Data from 655 women in a clinical trial comparing the Burch and fascial sling were examined. Improvement in QOL, measured with the Incontinence Impact Questionnaire (mean decrease 133.1; SD 109.8), was observed 6 months after surgery and persisted at 24 months. Women for whom surgery was successful (regardless of surgery type) had greater improvement in QOL (mean decrease 160.0; SD 103.9) than did women for whom surgery was not successful (mean decrease 113.6; SD 110.9; p < 0.0001), although not statistically significant after adjusting for covariates. Multivariable analysis showed that QOL improvement was related to decreased urinary incontinence (UI) symptom bother, greater improvement in UI severity, younger age, Hispanic ethnicity, and receiving Burch surgery. Among sexually active women, worsening sexual function had a negative impact on QOL. Improved QOL was explained most by UI symptom improvement.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hunskaar S, Vinsnes A (1991) The quality of life in women with urinary incontinence as measured by the Sickness Impact Profile. J Am Geriatr Soc 39:378–382
Schlenk E, Erlen J, Dunbar-Jacob J et al (1988) Health-related quality of life in chronic disorders: a comparison across studies using the MOS SF-36. Qual Life Res 7:57–65
Donovan J, Bosch R, Gotoh M, Jackson S, Naughton M, Radley S, Valiquette L (2005) Symptom and quality of life assessment. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence. 3rd International Consultation on Incontinence, Monaco, pp 519–558
Albo ME, Richter HE, Brubaker L et al (2007) Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 356:2143–2155
Tennstedt S, FitzGerald MP, Nager C, Xu Y, Zimmern P, Kraus S, Kusek J, Borello-France D, Mallett V, for the Urinary Incontinence Treatment Network (2007) Quality of life in women with stress urinary incontinence. Int Urogynecol J 18:543–549
Tennstedt S, Urinary Incontinence Treatment Network (2005) Design of the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr). Urology 66:1213–1217
Shumaker SA, Wyman JF, Uebersax JS, McClish D, Fantl JA (1994) Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program in Women (CPW) Research Group. Qual Life Res 3:291–306
Nam CB, Terrie EW (1988) 1980-based Nam–Powers occupational status scores. 1988 Working Paper 88-48. Center for the Study of Population, Florida State University, Tallahassee
Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17
Lose G, Jorgensen L, Thunedborg P (1989) 24-hour home pad weighing test versus 1-hour ward test in the assessment of mild stress incontinence. Acta Obstet Gynecol Scand 68:211
Herzog AR, Diokno AC, Brown MB, Normolle DP, Brock BM (1996) Two-year incidence, remission, and change patterns of urinary incontinence in noninstitutionalized older adults. J Gerontol 45:M67–M74
Rogers RG, Kammerer-Doak D, Villarreal A, Coates K, Qualls C (2001) A new instrument to measure sexual function in women with urinary incontinence or pelvic organ prolapse. Am J Obstet Gynecol 184:552–558
Acknowledgements
This work was supported by cooperative agreements from the National Institute of Diabetes and Digestive and Kidney Diseases with additional support from the National Institute of Child Health and Human Development and the Office of Research on Women’s Health, National Institutes of Health.
Unit steering committee
William Steers, MD, Chair (University of Virginia, Charlottesville, VA, USA); Ananias C. Diokno, MD (William Beaumont Hospital, Royal Oak, MI, USA: U01 DK58231); Salil Khandwala MD and Veronica Mallett, MD (Oakwood Hospital, Dearborn, MI, USA; U01 DK58231); Linda Brubaker, MD and Mary Pat FitzGerald, MD (Loyola University Medical Center, Maywood, IL, USA; U01 DK60379); Holly E. Richter, Ph.D., MD and L. Keith Lloyd, MD (University of Alabama, Birmingham, AL, USA; U01 DK60380); Michael Albo, MD and Charles Nager, MD (University of California, San Diego, CA, USA; U01 DK60401); Toby Chai, MD and Harry W. Johnson, MD (University of Maryland, Baltimore, MD, USA; U01 DK60397); Halina M. Zyczynski, MD and Wendy Leng, MD (University of Pittsburgh, Pittsburgh, PA, USA; U01 DK 58225); Philippe Zimmern, MD and Gary Lemack, MD (University of Texas Southwestern, Dallas, TX, USA; U01 DK60395); Stephen Kraus, MD and Thomas Rozanski, MD (University of Texas Health Sciences Center, San Antonio, TX, USA; U01 DK58234); Peggy Norton, MD and David Lesser, MD (University of Utah, Salt Lake City, UT, USA; U01 DK60393); Sharon Tennstedt, Ph.D. and Anne Stoddard, Sc.D. (New England Research Institutes, Watertown, MA, USA; U01 DK58229); Debuene Chang MD, John W. Kusek, Ph.D., and Leroy M. Nyberg, MD, Ph.D. (National Institute of Diabetes and Digestive and Kidney Diseases); Anne M. Weber, MD (National Institute of Child Health and Human Development).
Conflicts of interest
None.
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
About this article
Cite this article
Tennstedt, S.L., Litman, H.J., Zimmern, P. et al. Quality of life after surgery for stress incontinence. Int Urogynecol J 19, 1631–1638 (2008). https://doi.org/10.1007/s00192-008-0700-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-008-0700-1