INTRODUCTION AND HYPOTHESIS: The primary aim was to characterize stress urinary incontinence (SUI) symptom distress and impact after a midurethral sling (MUS) in women ≥70 compared to women <70 years of age. METHODS: A retrospective cohort study of women undergoing a primary MUS was conducted. The primary outcome was SUI symptoms defined as either "moderately" or "quite a bit" responses to ≥1 of the two SUI questions of the Pelvic Floor Distress Inventory-20 (PFDI-20). Urgency urinary incontinence (UUI) was defined as either moderately or quite a bit responses to the UUI question of the PFDI-20. The Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Satisfaction Questionnaire (PSQ), and Patient Global Impression of Improvement (PGI-I) questionnaires were also administered. RESULTS: The mean age of patients ≥70 years (n = 160) was 75.4 ± 4.5 and <70 years (n = 536) was 56.2 ± 9.4. Multivariable analysis revealed no difference in SUI failure rates in older compared to younger cohorts, adjusted odds ratio (OR) 1.7, 95 % confidence interval (CI) 0.9-3.1. Women <70 demonstrated greater improvement in urinary incontinence (UI) symptom impact [-20.4 (33.0) vs -12.2 (30.7), p = 0.01] and women ≥70 had greater persistent UUI symptoms (31.5 vs 23.3 %, p = 0.04); there was no difference between cohorts in resolution of UUI (29.6 vs 34.2 %, p = 0.34). Younger women reported a greater impression of improvement compared to older women (67.7 vs 56.6 %, p = 0.01, respectively). CONCLUSIONS: Older and younger women have similar SUI outcomes after MUS; however, older women have more persistent UUI and a worse impression of improvement of their urinary tract condition.
INTRODUCTION AND HYPOTHESIS: The primary aim was to characterize stress urinary incontinence (SUI) symptom distress and impact after a midurethral sling (MUS) in women ≥70 compared to women <70 years of age. METHODS: A retrospective cohort study of women undergoing a primary MUS was conducted. The primary outcome was SUI symptoms defined as either "moderately" or "quite a bit" responses to ≥1 of the two SUI questions of the Pelvic Floor Distress Inventory-20 (PFDI-20). Urgency urinary incontinence (UUI) was defined as either moderately or quite a bit responses to the UUI question of the PFDI-20. The Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Satisfaction Questionnaire (PSQ), and Patient Global Impression of Improvement (PGI-I) questionnaires were also administered. RESULTS: The mean age of patients ≥70 years (n = 160) was 75.4 ± 4.5 and <70 years (n = 536) was 56.2 ± 9.4. Multivariable analysis revealed no difference in SUI failure rates in older compared to younger cohorts, adjusted odds ratio (OR) 1.7, 95 % confidence interval (CI) 0.9-3.1. Women <70 demonstrated greater improvement in urinary incontinence (UI) symptom impact [-20.4 (33.0) vs -12.2 (30.7), p = 0.01] and women ≥70 had greater persistent UUI symptoms (31.5 vs 23.3 %, p = 0.04); there was no difference between cohorts in resolution of UUI (29.6 vs 34.2 %, p = 0.34). Younger women reported a greater impression of improvement compared to older women (67.7 vs 56.6 %, p = 0.01, respectively). CONCLUSIONS: Older and younger women have similar SUI outcomes after MUS; however, older women have more persistent UUI and a worse impression of improvement of their urinary tract condition.
Authors: Holly E Richter; Michael E Albo; Halina M Zyczynski; Kimberly Kenton; Peggy A Norton; Larry T Sirls; Stephen R Kraus; Toby C Chai; Gary E Lemack; Kimberly J Dandreo; R Edward Varner; Shawn Menefee; Chiara Ghetti; Linda Brubaker; Ingrid Nygaard; Salil Khandwala; Thomas A Rozanski; Harry Johnson; Joseph Schaffer; Anne M Stoddard; Robert L Holley; Charles W Nager; Pamela Moalli; Elizabeth Mueller; Amy M Arisco; Marlene Corton; Sharon Tennstedt; T Debuene Chang; E Ann Gormley; Heather J Litman Journal: N Engl J Med Date: 2010-05-17 Impact factor: 91.245
Authors: Charles W Nager; Larry Sirls; Heather J Litman; Holly Richter; Ingrid Nygaard; Toby Chai; Stephen Kraus; Halina Zyczynski; Kim Kenton; Liyuan Huang; John Kusek; Gary Lemack Journal: J Urol Date: 2011-06-16 Impact factor: 7.450
Authors: Alison M Parden; Jonathan L Gleason; Victoria Jauk; Rachel Garner; Alicia Ballard; Holly E Richter Journal: Obstet Gynecol Date: 2013-02 Impact factor: 7.661
Authors: Philip Toozs-Hobson; Pooja Devani; Joseph Pick; Paul A Moran; Philip Assassa; Claire Burton Journal: Int Urogynecol J Date: 2016-03-18 Impact factor: 2.894