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Surgical preparation: are patients “ready” for stress urinary incontinence surgery?

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Abstract

Introduction and hypothesis

Patient preparedness for stress urinary incontinence (SUI) surgery is associated with improvements in post-operative satisfaction, symptoms and quality of life (QoL). This planned secondary analysis examined the association of patient preparedness with surgical outcomes, treatment satisfaction and quality of life.

Methods

The ValUE trial compared the effect of pre-operative urodynamic studies with a standardized office evaluation of outcomes of SUI surgery at 1 year. In addition to primary and secondary outcome measures, patient satisfaction with treatment was measured using a five-point Likert scale (very dissatisfied to very satisfied) that queried subjects to rate the treatment’s effect on overall incontinence, urge incontinence, SUI, and frequency. Preparedness for surgery was assessed using an 11-question Patient Preparedness Questionnaire (PPQ).

Results

Based on PPQ question 11, 4 out of 5 (81 %) of women reported they “agreed” or “strongly agreed” that they were prepared for surgery. Selected demographic and clinical characteristics were similar in unprepared and prepared women. Among SUI severity baseline measures, total UDI score was significantly but weakly associated with preparedness (question 11 of the PPQ; Spearman's r = 0.13, p = 0.001). Although preparedness for surgery was not associated with successful outcomes, it was associated with satisfaction (r s = 0.11, p = 0.02) and larger PGI-S improvement (increase; p = 0.008).

Conclusions

Approximately half (48 %) of women “strongly agreed” that they felt prepared for SUI. Women with higher pre-operative preparedness scores were more satisfied, although surgical outcomes did not differ.

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Acknowledgements

Supported by cooperative agreements from the National Institute of Diabetes and Digestive and Kidney Diseases, U01 DK58225, U01 DK58229, U01 DK58234, U01 DK58231, U01 DK60379, U01 DK60380, U01 DK60393, U01 DK60395, U01 DK60397, and U01 DK60401. Support was also provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Conflicts of interest

The following is a list of disclosures from the authors:

A.D. Markland is sponsored by the Department of Veterans Affairs and has a VA sponsored grant.

L. Brubaker, E. Casiano, C. Ghetti, J.W. Kusek, H.J. Litman, M.F.R. Paraiso, K.Y. Dyer, D.D. Rahn do not have any disclosures to report.

E. Sirls is sponsored by Johnson & Johnson.

L. Rickey is sponsored by Pfizer.

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Authors and Affiliations

  1. Departments of OG and Urology, Loyola University Chicago, Stritch School of Medicine, 2160 South First Avenue, Maywood, Chicago, IL, 60153, USA

    L. Brubaker

  2. New England Research Institutes, Watertown, MA, USA

    H. J. Litman

  3. Department of Urology, University of Maryland, Baltimore, MD, USA

    L. Rickey

  4. Department of Obstetrics and Gynecology, Kaiser Permanente, San Diego, CA, USA

    K. Y. Dyer

  5. Department of Veterans Affairs and the Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA

    A. D. Markland

  6. Department of Urology, William Beaumont Hospital, Royal Oak, MI, USA

    L. Sirls

  7. Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA

    P. Norton

  8. Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, San Antonio, TX, USA

    E. Casiano

  9. Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA

    M. F. R. Paraiso

  10. Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA, USA

    C. Ghetti

  11. Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    D. D. Rahn

  12. National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA

    J. W. Kusek

Authors
  1. L. Brubaker
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  2. H. J. Litman
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  3. L. Rickey
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  4. K. Y. Dyer
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  5. A. D. Markland
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  6. L. Sirls
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  7. P. Norton
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  8. E. Casiano
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  9. M. F. R. Paraiso
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  10. C. Ghetti
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  11. D. D. Rahn
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  12. J. W. Kusek
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Corresponding author

Correspondence to L. Brubaker.

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Brubaker, L., Litman, H.J., Rickey, L. et al. Surgical preparation: are patients “ready” for stress urinary incontinence surgery?. Int Urogynecol J 25, 41–46 (2014). https://doi.org/10.1007/s00192-013-2184-x

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  • DOI: https://doi.org/10.1007/s00192-013-2184-x

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