Urology · 2002
Medium-term follow-up of transvaginal suburethral slings: variance in outcome success using two different evaluation methods.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Franco Nicholas, Shobeiri S Abbas, Echols Karolynn T
Аннотация
OBJECTIVES: To compare Groutz-Blaivas' Simplified Urinary Incontinence Outcome Score (SUIOS) with retrospective chart review for medium-term evaluation of transvaginal suburethral slings.
METHODS: A total of 127 consecutive women underwent transvaginal suburethral sling surgery using In-fast bone screw technology, with a fascia lata graft, from April 1997 to September 1998 (30-month follow-up), performed by a single method. Retrospective evaluation of the patients' office charts was compared with the outcome data determined by the previously validated SUIOS.
RESULTS: Of the 107 available patients, 65 (61%) responded. When evaluating the patients' charts retrospectively, we obtained a complete cure of urinary stress incontinence in 59 (91%), improvement in 3 (4.5%), and complete failure in 3 (4.5%) of the 65 women. Of the 65 patients, 9 (13.5%) reported urge incontinence. The overall urge de novo rate was 9% (6 of 65). On the basis of the SUIOS, 24 (37%) were cured, 22 (34%) had good results, and 10 (15%) of the 65 women had a fair response. By SUIOS, 21 (60%) of 35 patients with mixed incontinence continued having urge incontinence episodes postoperatively compared with 16 (53%) of 30 patients without documented preoperative urge incontinence who developed de novo urge incontinence postoperatively (P <0.05).
CONCLUSIONS: Despite extensive preoperative counseling, patients perceive any kind of postoperative urinary incontinence as a poor outcome. However, we, as physicians, regard success as cure of the stress component when the surgical intervention is concerned. A validated simplified urinary incontinence score represents a more objective account of the outcome.
METHODS: A total of 127 consecutive women underwent transvaginal suburethral sling surgery using In-fast bone screw technology, with a fascia lata graft, from April 1997 to September 1998 (30-month follow-up), performed by a single method. Retrospective evaluation of the patients' office charts was compared with the outcome data determined by the previously validated SUIOS.
RESULTS: Of the 107 available patients, 65 (61%) responded. When evaluating the patients' charts retrospectively, we obtained a complete cure of urinary stress incontinence in 59 (91%), improvement in 3 (4.5%), and complete failure in 3 (4.5%) of the 65 women. Of the 65 patients, 9 (13.5%) reported urge incontinence. The overall urge de novo rate was 9% (6 of 65). On the basis of the SUIOS, 24 (37%) were cured, 22 (34%) had good results, and 10 (15%) of the 65 women had a fair response. By SUIOS, 21 (60%) of 35 patients with mixed incontinence continued having urge incontinence episodes postoperatively compared with 16 (53%) of 30 patients without documented preoperative urge incontinence who developed de novo urge incontinence postoperatively (P <0.05).
CONCLUSIONS: Despite extensive preoperative counseling, patients perceive any kind of postoperative urinary incontinence as a poor outcome. However, we, as physicians, regard success as cure of the stress component when the surgical intervention is concerned. A validated simplified urinary incontinence score represents a more objective account of the outcome.