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

被引:50
作者
Rodriguez, LV [1 ]
Raz, S [1 ]
机构
[1] Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90024 USA
关键词
urethra; urinary incontinence; stress; polypropylene; prostheses and implants; questionnaires;
D O I
10.1097/01.ju.0000083327.26420.99
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: We evaluated the safety and efficacy of the distal urethral polypropylene sling for stress urinary incontinence using patient self-assessment by questionnaires. Materials and Methods: We performed a prospective study of all consecutive patients who underwent a mid distal urethral sling procedure between November 1999 and February 2002. Surgical outcome was determined by symptom, bother and quality of life questionnaires completed by the patients. The physicians were blinded to patient responses. These outcomes were compared to the SEAPI determined by the physician and to physical examination findings. Results: There were 301 patients, of whom 2.3% required treatment for persistent stress urinary incontinence (SUI) after the polypropylene sling procedure. In the 92 patients with a minimum followup of 12 months the objective cure rate was 92%. The patient determined subjective success rate (cure and improved greater than 50%) was 89%. On questionnaires only 69% of the patients reported no symptoms of SUI under any circumstance and the same number reported never being bothered by SUI. The physician determined SEAPI overestimated patient self-reported symptoms by 10% to 50% depending on the symptom. Conclusions: The polypropylene sling represents an inexpensive, safe and simple alternative treatment for patients with stress urinary incontinence. The procedure provides high objective and physician determined cure rates but a lower patient self-reported subjective cure rate. Patient self-assessment of symptoms, bother and quality of life should be an integral part of the outcome of stress urinary incontinence surgery.
引用
收藏
页码:857 / 863
页数:7
相关论文
共 21 条
[1]   Outcome in 104 pubovaginal slings using freeze-dried allograft fascia lata from a single tissue bank [J].
Amundsen, CL ;
Visco, AG ;
Ruiz, H ;
Webster, GD .
UROLOGY, 2000, 56 (6A) :2-8
[2]  
Blaivas JG, 1997, NEUROUROL URODYNAM, V16, P145, DOI 10.1002/(SICI)1520-6777(1997)16:3<145::AID-NAU2>3.0.CO
[3]  
2-E
[4]   Quality of life assessment in men and women with urinary incontinence [J].
Corcos, J ;
Beaulieu, S ;
Donovan, J ;
Naughton, M ;
Gotoh, M .
JOURNAL OF UROLOGY, 2002, 168 (03) :896-905
[5]   Our experience with pubovaginal slings in patients with stress urinary incontinence [J].
Cross, CA ;
Cespedes, RD ;
McGuire, EJ .
JOURNAL OF UROLOGY, 1998, 159 (04) :1195-1198
[6]   Results of pubovaginal sling for the treatment of intrinsic sphincteric deficiency determined by questionnaire analysis [J].
Haab, F ;
Trockman, BA ;
Zimmern, PE ;
Leach, GE .
JOURNAL OF UROLOGY, 1997, 158 (05) :1738-1741
[7]   Objective and subjective cure rates after tension-free vaginal tape for treatment of urinary incontinence [J].
Jeffry, L ;
Deval, B ;
Birsan, A ;
Soriano, D ;
Darai, E .
UROLOGY, 2001, 58 (05) :702-706
[8]   CRITERION VALIDITY AND RELIABILITY OF THE SF-36 IN A POPULATION-SAMPLE [J].
JENKINSON, C ;
WRIGHT, L ;
COULTER, A .
QUALITY OF LIFE RESEARCH, 1994, 3 (01) :7-12
[9]   Urinary retention after tension-free vaginal tape procedure: Incidence and treatment [J].
Klutke, C ;
Siegel, S ;
Carlin, B ;
Paszkiewicz, E ;
Kirkemo, A ;
Klutke, J .
UROLOGY, 2001, 58 (05) :697-701
[10]   The tension-free vaginal tape procedure: Correction of stress incontinence with minimal alteration in proximal urethral mobility [J].
Klutke, JJ ;
Carlin, BI ;
Klutke, CG .
UROLOGY, 2000, 55 (04) :512-514