To perform a national survey on self-reported cure, satisfaction and complications four years after mid-urethral sling (MUS) for urinary stress incontinence in Danish women operated in 2001.
A postal questionnaire survey.
All Danish women who received an MUS operation in 2001 extracted from the Danish National Patient Register.
The women received a validated postal questionnaire in 2005. The questionnaire included questions about subjective cure, satisfaction, complications and a Danish version of International Consultation on Incontinence Questionnaire-Short Form. The study was carried out in cooperation with the Danish National Board of Health.
A total of 335 (92%) women responded to the questionnaire, among whom 105 (32%) felt completely cured, 119 (36%) were much improved, 55 (17%) were improved and 48 (15%) unchanged or worse. Cure rate varied between departments from 0% to 67%. Low-volume departments (<10 operations/year) had a significantly (p = 0.05) lower cure rate compared to the department with a higher volume. Altogether, 238 (73%) women were very satisfied with their operation. Self-reported bladder emptying difficulties were reported by 103 (32%) and the need for clean intermittent catherization (CIC) at any stage was reported by 21 (7%). No woman was still performing CIC. Of the women, 126 (42%) had made contact with the healthcare system because of their operation after discharge from hospital.
Long-term outcome of MUS operations in Denmark in terms of cure, satisfaction and complication rates seems comparable to international results; however, the decentralized organization with many low-volume departments seems inappropriate.
[Show abstract][Hide abstract] ABSTRACT: Introduction and hypothesis:
Retropubic tension-free vaginal tape (TVT) was introduced in 1996 as a new and innovative surgical approach in the treatment of stress urinary incontinence (SUI). In this study we evaluate the long-term objective and subjective outcomes in a non-selected patient population 10 years after the retropubic TVT procedure.
All women (603) operated on with retropubic TVT at four gynecological departments from September 1998 through December 2000 were identified, and those still alive (542) were invited to participate in this population-based prospective study. For subjective data a short-form urinary incontinence disease-specific questionnaire was used. For objective evaluation the women underwent a stress test. Data collected were merged with previously stored data in the Norwegian National Incontinence Registry Database.
We included 483 women; 327 attended a clinical follow-up consultation and 156 had a telephone interview. Median duration of follow-up was 129 months. Objective cure rate was 89.9 %, subjective cure rate was 76.1 %, and 82.6 % of the patients stated they were "very satisfied" with their surgery (treatment satisfaction rate). Only 2.3 % of the women had undergone repeat SUI surgery. Subjective voiding difficulties were reported by 22.8 %, the majority describing slow stream or intermittency. De novo urgency incontinence increased significantly from 4.1 % 6-12 months after surgery to 14.9 % at the 10-year follow-up.
Long-term objective and subjective outcome after retropubic TVT is excellent with a low number of re-operations even in a non-selected cohort of patients.
International Urogynecology Journal 02/2013; 24(8). DOI:10.1007/s00192-013-2058-2 · 1.96 Impact Factor
Nicole M Fromm, David B Salisbury, Simon J Driver, Marie N Dahdah, Kimberley R Monden
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