Article

Prevalence and outcomes of continence surgery in community dwelling women.

Department of Urology, William Beaumont Hospital, Royal Oak, Michigan, USA.
The Journal of Urology (Impact Factor: 3.7). 09/2003; 170(2 Pt 1):507-11. DOI: 10.1097/01.ju.0000070404.24755.35
Source: PubMed

ABSTRACT Published outcomes of continence surgery are based largely on cohort studies and a smaller number of randomized trials. There is no consensus on the outcomes that should be considered and patient reported outcomes have not always been included. We determined the prevalence of continence surgery as well as patient reported outcomes in community dwelling women.
We performed a 2-stage national cross-sectional mailed survey. A short questionnaire used to identify women with a history of continence surgery was sent to 45,000 representative American households. Eligible women with a history of continence surgery received a followup questionnaire to assess patient reported outcomes, including current symptom frequency, bother and overall satisfaction.
Of the 24,581 women 967 (4%) had a history of continence surgery, including 73% who currently reported incontinence in the preceding month, 58% who reported incontinence in the preceding week and 53% who reported current use of pads or other absorbent material. Of those who reported incontinence 83% reported current stress incontinence symptoms, including 62% with stress and urge symptoms. A third of the women had been treated with surgery in the last 5 years. The proportion of women satisfied with the results of surgery decreased from 67% who recalled initial satisfaction to 45% who reported current satisfaction.
Almost 4% of women had undergone continence surgery and continence rates were lower than most published figures. However, some women reported satisfaction with surgery even when they did not achieve continence. Patient satisfaction and other patient reported outcomes might be considered with continence rates when determining surgical success rates.

0 Bookmarks
 · 
49 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study is to investigate the expression of calpain-1, calpain-2, and calpastatin in the human periurethral vaginal tissues and to show the potential link between calpain system and stress urinary incontinence (SUI). The periurethral vaginal tissues of 39 women with SUI and 31 women without SUI were collected to detect the expressions of calpains and calpastatin by using semi-quantitative competitive reverse transcription-polymerase chain reaction and Western blotting. There were no significant differences on the expressions of calpain-1 at the levels of messenger RNA (mRNA) and protein in both groups (P > 0.05), but the patients with SUI had significantly higher levels of calpain-2 mRNA and protein than the control (P < 0.05); and the mRNA expressions of calpastatin in women with SUI were significantly higher than the control (P < 0.05), while the protein expressions were significantly lower when compared to the control (P < 0.01). Overexpression of calpain-2 and low expression of calpastatin may involve in the pathological development of SUI.
    International Urogynecology Journal 09/2009; 21(1):63-8. · 2.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We wondered if the tension-free vaginal tape approach, introduced in 1998, influenced the rate of anti-incontinence surgery. We determined the rates of anti-incontinence surgery in Belgium between 1997 and 2007, using the Belgian National Health Insurance Fund register covering the entire adult female population of nearly 4,420,000 women in Belgium. The rate per 1,000 women of anti-incontinence surgery increased from 0.54 in 1997 to 2.03 in 2004, after which a plateau was reached (2.01 in 2007). This nearly fourfold increase coincided with the introduction in 1998 on the Belgian market of the tension-free vaginal tape (+66% more interventions between 1998 and 2001). After the introduction of the transobturator tape in 2001, the rate increased even more dramatically (+118% between 2001 and 2004). Rates of anti-incontinence surgery increased by 272% in Belgium between 1997 and 2007. This increase coincided with the availability of tension-free mesh sling operations.
    International Urogynecology Journal 12/2010; 21(12):1511-5. · 2.17 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Longitudinal data for studying urinary incontinence (UI) risk factors are rare. Data from one study, the hallmark Medical, Epidemiological, and Social Aspects of Aging (MESA), have been analyzed in the past; however, repeated measures analyses that are crucial for analyzing longitudinal data have not been applied. We tested a novel application of statistical methods to identify UI risk factors in older women. MESA data were collected at baseline and yearly from a sample of 1955 men and women in the community. Only women responding to the 762 baseline and 559 follow-up questions at one year in each respective survey were examined. To test their utility in mining large data sets, and as a preliminary step to creating a predictive index for developing UI, logistic regression, generalized estimating equations (GEEs), and proportional hazard regression (PHREG) methods were used on the existing MESA data. The GEE and PHREG combination identified 15 significant risk factors associated with developing UI out of which six of them, namely, urinary frequency, urgency, any urine loss, urine loss after emptying, subject's anticipation, and doctor's proactivity, are found most highly significant by both methods. These six factors are potential candidates for constructing a future UI predictive index.
    Advances in Urology 01/2012; 2012:276501.