Measuring outcomes of importance to women with stress urinary incontinence.

Health Economics Research Unit, University of Aberdeen, Aberdeen, UK.
BJOG An International Journal of Obstetrics & Gynaecology (Impact Factor: 3.76). 05/2009; DOI: 10.1111/j.1471-0528.2008.02106.x
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    ABSTRACT: to evaluate and compare the effects of body mass index (BMI) on the severity of female urinary incontinence (UI) using the quality of life questionnaire King's Health Questionnaire (KHQ), variables of urodynamic studies and the medical history taken. cross-sectional clinical study. We selected 65 patients with stress urinary incontinence (SUI) who were divided into three groups: Group I (BMI: 18-25 kg/m²), Group II (BMI: 25-30 kg/m²) and Group III (BMI>30 kg/m²). The KHQ domains were compared between these groups. In addition, some clinical history urodynamic data (presence of nocturia, enuresis, urgency and urge incontinence) were also related to BMI by calculating the Odds Ratio (OR). The BMI in the presence and absence of non-inhibited detrusor contractions and Valsalva leak point pressure (VLPP) <60 or > 60 cmH2O were evaluated. Finally, the correlation between BMI and the nine KHQ domains has been tested in order to detect some association. the KHQ did not record deterioration of quality of life in women with UI with increasing BMI in any of its areas. The OR for the presence of enuresis in relation to a BMI was 1.003 [CI: 0.897-1.121], p=0.962. The OR for nocturia was 1.049 [CI: 0.933-1.18], p=.425. The OR for urgency was 0.975 [CI: 0.826-1.151], p=0.762, and the OR for incontinence was 0.978 [CI: 0.85-1.126], p=0.76. We studied the BMI in patients with and without non-inhibited detrusor contractions and detected medians of 26.4 ± 4.8 and 28.3 ± 5.7 kg/m², respectively (p=0.6). Similarly, the median BMI values for the groups with VLPP <60 and >60 cmH2O were 29.6 ± 4.1 and 27.7 ± 5.7 kg/m², respectively (p=0.2). Finally, we failed to demonstrate an association between BMI and any of the nine KHQ domains by means of the Spearman correlation. there was no association of KHQ scores with BMI. There was also no correlation between the parameters of clinical history and of the urodynamic study with BMI.
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    ABSTRACT: The purpose of this study was to identify goals of fecal incontinence (FI) management and their importance to community-living adults if complete continence would not be possible. Participants expressed their goals of FI management in a semistructured interview, selected others from 12 investigator-identified goals, and rated their importance. Five thematic categories emerged from the 114 participant-identified goal statements: Fecal Incontinence/Bowel Pattern, Lifestyle, Emotional Responses, Adverse Effects of Fecal Incontinence, and Self-Care Practices. Participants selected a median of seven investigator-identified goals (range = 2 to 12). Goals selected by the most participants were decreased number of leaks of stool and greater confidence in controlling fecal incontinence. These goals also had the highest importance along with decreased leakage of loose or liquid stool. The type and number of management goals identified by participants offer a toolbox of options from which to focus therapy when cure is not possible and promote patient satisfaction.
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    ABSTRACT: PURPOSE: The aim of this study was to assess the relationship between long term quality of life (QoL), patient satisfaction, and Pelvic Organ Prolapse Quantification (POPQ) scores following anterior vaginal repair with mesh. METHODS: This cross-sectional study included 127 patients who underwent anterior pelvic floor repair with mesh and were assessed 1.03-2.69 years post surgery. One hundred and four women completed the King's Health Questionnaire (KHQ), the Sheffield Prolapse Symptoms Questionnaire, the EurolQoL EQ-5D, and the Patient Satisfaction Index. POPQ scores were recorded for up to 1 year. RESULTS: Patients reported good current QoL and high patient satisfaction. POPQ Aa and Ba scores showed significant improvements from a pre-surgery median of +1 to a median of -3 at 12-month follow-up (P < .001). Patient satisfaction was inversely correlated with Aa scores at 12 months (r (s) = -.360, n = 49, P < .011). There were high QoL scores at an average 2 years after anterior compartment mesh repair. CONCLUSIONS: QoL outcomes were good. There was a significant relationship between Aa scores and patient satisfaction, suggesting that this outcome is a key to patient satisfaction.
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