Patient satisfaction and objective outcome assessment following mid-urethral sling procedures in women with stress urinary incontinence: A prospective study
Abstract Background Mid-urethral sling (MUS) operations are currently a recognized as the most popular and effective procedures for the surgical treatment of stress urinary incontinence (SUI) among women population. However, data reporting a long-term outcome is still equivocal, and thus, the data available are limited. This study aims to examine the efficacy of MUS operations after implantation for the treatment of women SUI during 3-years follow up. Method A prospective study was conducted in referral centers in the Tehran University of Medical Science, Emam Khomeini Hospital, Iran. 105 patients with urodynamically proven pure SUI or mix incontinence treated by MUS surgeries (TOT-TVT) were included. Patients with history of prior anti-incontinence surgery and abdominal radical pelvic surgery were excluded. Data regarding objective cure rates, subjective outcomes (Urogenital Distress Inventory Questionnaire–Short Form, Surgical Satisfaction Questionnaire) were collected during follow-up. We analyzed the preoperative parameters by univariate and multivariate analysis was conducted to investigate outcomes. Results One hundred five women had MUS implantation. At 4-years follow-up, 101 women (95%) were available for the assessment. We find evidence of significant improvement in urinary symptoms, objective cure rates and patient satisfaction after operation. At 3-years follow up, 80 of 101 women (82.17%) indicated themselves cured. Similarly, at 3-years evaluation, 83 of 101 women (82.17%) were satisfied or very satisfied, not showing visible urine leakage; and a state that did not need interval surgery. The multivariate analysis of the preoperative parameters revealed that age, VD, absences of urgency symptoms were the parameters related independently to the surgical success and patient’s satisfaction and Qmax was well associated with postoperative voiding dysfunction (PVD). Conclusion The 4-years findings of this study suggest that MUS surgeries are an effective procedures for the treatment of SUI.
