Comparison of functional outcomes and quality of life after surgical treatment of stress urinary incontinence in women
DOI:
https://doi.org/10.15574/HW.2024.171.38Keywords:
stress urinary incontinence, sling, pelvic surgery, quality of life, womenAbstract
Sling surgery is a modern and effective surgical treatment for stress urinary incontinence in women. However, there is insufficient data on the comparative analysis of long-term results and quality of life of patients after various options of such operations.
Purpose - to compare the functional results and quality of life of women after two variants of sling operations for stress urinary incontinence.
Materials and methods. 84 women with stress urinary incontinence were examined, who were divided into two groups. In the Group I, a plastic free synthetic loop (TVT) was performed, in the Group II - an operation using the transobturator location of the prolene loop (TVT-Obturator - TVT-О). Functional outcomes of treatment and quality of life were assessed 2 years after surgery using the ICIQ-SF questionnaire, the Patient General Impression of Improvement (PGI-I) scale, and the Patient Satisfaction Scale. An objective indicator was the absence of leakage of urine during a cough test.
Results. Treatment effectiveness, according to objective criteria, was 87.9% and 67.9% 2 years after TVT and TVT-O surgery, respectively (p=0.045). When evaluating subjective indicators, no statistically significant differences between groups were found, however, according to the ICIQ-SF questionnaire, the frequency of improvement in the quality of life was reliably 1.3 times higher in the case of using the TVT technique (odds ratio 3.33; 95% confidence interval 1.14-9.78). The frequency of urinary incontinence recurrence did not depend on the method of sling operation (p>0.05). Data analysis was carried out using The Statistical Package for Social Sciences.
Conclusions. When evaluating the results of treatment 2 years after the intervention, the effectiveness of TVT surgery, according to objective criteria, is statistically significantly higher than the effectiveness of TVT-O surgery, although the latter technique is associated with the absence of bladder etching.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Abdel-Fattah M, Ramsay I, Pringle S, Hardwick C, Ali H et al. (2011). Evaluation of transobturator tension-free vaginal tapes in management of women with recurrent stress urinary incontinence. Urology. 77 (5): 1070-1075. https://doi.org/10.1016/j.urology.2011.01.016; PMid:21414653
Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al. (2003). The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 61 (1): 37-49. https://doi.org/10.1016/S0090-4295(02)02243-4; PMid:12559262
Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. (2017). Urinary incontinence in women. Nat Rev Dis Primers. 3: 17042. https://doi.org/10.1038/nrdp.2017.42; PMid:28681849 PMCid:PMC5878864
Barber MD, Spino C, Janz NK, Brubaker L, Nygaard I, Nager CW et al. (2009). The minimum important differences for the urinary scales of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire. Am J Obstet Gynecol. 200 (5): 580.e1-7. https://doi.org/10.1016/j.ajog.2009.02.007; PMid:19375574 PMCid:PMC2680021
Blaivas JG. (1988). Stress Incontinence: Classification and Surgical Approach. J Urol. 139(4): 727-731. https://doi.org/10.1016/S0022-5347(17)42611-5; PMid:3352031
Campeau L, Tu LM, Lemieux MC, Naud A, Karsenty G et al. (1007). A multicenter, prospective, randomized clinical trial comparing tension-free vaginal tape surgery and no treatment for the management of stress urinary incontinence in elderly women. Neurourol. Urodyn. 26 (7): 990-994. https://doi.org/10.1002/nau.20440; PMid:17638307
Dowling-Castronovo A., Bradway C. (2016). Urinary Incontinence. In M. Boltz, E. Capezuti, T.T. Fulmer & D. Zwicker (Eds.), A. O'Meara (Managing Ed.).Evidence-Based Geriatric Nursing Protocols for Best Practice. 5th ed. New York: Springer Publishing Company. Chapter 21: 343-362.
Elers J, Hornum Bing M, Birkefoss K, Rohde JF, Ussing A, Glavind K. (2021). TVT or TVT-O? - A systematic review and meta-analysis comparing efficacy, complications and re-operations. Eur J Obstet Gynecol Reprod Biol. 258: 146-151. https://doi.org/10.1016/j.ejogrb.2020.12.005; PMid:33422775
Ford AA, Rogerson L, Cody JD, Aluko P, Ogah JA. (2017). Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 7 (7): CD006375. https://doi.org/10.1002/14651858.CD006375.pub4; PMid:28756647 PMCid:PMC6483329
Gorovyy VI, Yatsyna OI. (2019). Anatomiia stresovoho netrymannia sechi u zhinok. Medychni aspekty zdorovia zhinky. 6 (127): 47-62.
Harland N, Walz S, Eberli D, Schmid FA, Aicher WK et al. (2023). Stress Urinary Incontinence: An Unsolved Clinical Challenge. Biomedicines. 11 (9): 2486. https://doi.org/10.3390/biomedicines11092486; PMid:37760927 PMCid:PMC10525672
Hogewoning CR, Gietelink L, Pelger RC, Hogewoning CJ, Bekker MD, Elzevier HW. (2015). The introduction of mid-urethral slings: an evaluation of literature. Int Urogynecol J. 26 (2): 229-234. https://doi.org/10.1007/s00192-014-2488-5; PMid:25143007
Labrie J, Berghmans BL, Fischer K, Milani AL, van der Wijk I, Smalbraak DJ et al. (2013). Surgery versus physiotherapy for stress urinary incontinence. N Engl J Med. 2369 (12): 1124-1133. https://doi.org/10.1056/NEJMoa1210627; PMid:24047061
Lee UJ, Feinstein L, Ward JB, Kirkali Z, Martinez-Miller EE et al. (2021). Prevalence of Urinary Incontinence among a Nationally Representative Sample of Women, 2005-2016: Findings from the Urologic Diseases in America Project. J Urol. 205 (6): 1718-1724. https://doi.org/10.1097/JU.0000000000001634; PMid:33605795
Lucas MG, Bosch RJ, Burkhard FC, Cruz F, Madden TB, Nambiar AK et al. (2012). EAU guidelines on surgical treatment of urinary incontinence. Eur Urol. 62 (6): 1118-1129. https://doi.org/10.1016/j.eururo.2012.09.023; PMid:23040204
Lukacz ES, Santiago-Lastra Y, Albo ME, Brubaker L. (2017). Urinary incontinence in women. A review. JAMA. 318 (16): 1592-1604. https://doi.org/10.1001/jama.2017.12137; PMid:29067433
Patel UJ, Godecker AL, Giles DL, Brown HW. (2022). Updated Prevalence of Urinary Incontinence in Women: 2015-2018 National Population-Based Survey Data. Female Pelvic Med Reconstr Surg. 28 (4): 181-187. https://doi.org/10.1097/SPV.0000000000001127; PMid:35030139
Sandvik H, Espuna M, Hunskaar S. (2006). Validity of the incontinence severity index: comparison with pad-weighing tests. Int Urogynecol J Pelvic Floor Dysfunc. 17 (5): 520-524. https://doi.org/10.1007/s00192-005-0060-z; PMid:16547687
Song P, Wen Y, Huang C, Wang W, Yuan N, Lu Y et al. (2018). The efficacy and safety comparison of surgical treatments for stress urinary incontinence: A network meta-analysis. Neurourol Urodyn. 37 (4):1199-1211. https://doi.org/10.1002/nau.23468; PMid:29331033
Sung VW, Richter HE, Moalli P, Weidner AC, Nguyen JN, Smith AL et al. (2021). Characteristics Associated With Treatment Failure 1 Year After Midurethral Sling in Women With Mixed Urinary Incontinence. Obstet Gynecol. 138 (2): 199-207. https://doi.org/10.1097/AOG.0000000000004444; PMid:34237755 PMCid:PMC10184494
Todhunter-Brown A, Hazelton C, Campbell P, Elders A, Hagen S, McClurg D. (2022). Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 9 (9): CD012337.; https://doi.org/10.1002/14651858.CD012337.pub2; PMid:36053030 PMCid:PMC9437962
Tommaselli GA, Di Carlo C, Formisano C, Fabozzi A, Nappi C. (2015). Medium-term and long-term outcomes following placement of midurethral slings for stress urinary incontinence: a systematic review and metaanalysis. Int Urogynecol J. 26 (9): 1253-1268. https://doi.org/10.1007/s00192-015-2645-5; PMid:25990203
Townsend MK, Danforth KN, Lifford KL, Rosner B, Curhan GC et al. (2007). Incidence and remission of urinary incontinence in middle-aged women. Am J Obstet Gynecol. 197 (2): 167.e1-5. https://doi.org/10.1016/j.ajog.2007.03.041; PMid:17689637 PMCid:PMC3025861
Wu JM, Kawasaki A. (2011). Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050. Am J Obstet Gynecol. 205 (3): 230.e1-230.e5. https://doi.org/10.1016/j.ajog.2011.03.046; PMid:21600549 PMCid:PMC3630997
Yalcin I, Bump RC. (2003). Validation of two global impression questionnaires for incontinence. Am. J. Obstet. Gynecol. 189 (1): 98-101. https://doi.org/10.1067/mob.2003.379; PMid:12861145
Yatsyna OI. (2018). Yakist zhyttia zhinok v yii vzaiemozviazku iz poshyrenistiu rozladiv sechovypuskannia v Ukraini. Ukr. nauk.-prakt. zhurn. urolohiv, androlohiv ta nefrolohi. 22 (4): 17-23.
Zullo MA, Schiavi MC, Luffarelli P, Prata G, Di Pinto A, Oliva C. (2020). TVT-O vs. TVT-Abbrevo for stress urinary incontinence treatment in women: a randomized trial. Int Urogynecol J. 31 (4): 703-710. https://doi.org/10.1007/s00192-019-04077-7; PMid:31410518
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Ukrainian Journal Health of Woman
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
