RESUMO
PURPOSE: This study was designed to objectively assess the impediment of incontinence to quality of life (QoL) in females and its improvement by the midurethral sling (MUS) procedure. MATERIALS AND METHODS: From June 2006 to June 2007, 93 female patients underwent the MUS procedure at our institute because of urinary incontinence. The incontinence quality of life (I-QoL) questionnaire was administered to measure the QoL of the incontinent patients before and 1 and 12 months after the MUS procedure. Preoperative data and urodynamic factors were analyzed retrospectively by I-QoL scores to identify factors that may affect the QoL of incontinent patients. RESULTS: The average preoperative I-QoL score of the 93 patients was 61.1+/-21.0 points. At 1 year after surgery, the average I-QoL score was found to have improved to 98.4+/-20.7 points. There were no significant differences between stress and mixed urinary incontinence in terms of cure and satisfaction (p>0.05). I-QoL scores of the cured and improved patients increased at 1 year after surgery (p<0.01). There were no statistically significant differences in the increment of I-QoL between cured and improved patients (p>0.05). Although urinary urgency and large urine leak amounts significantly reduced preoperative QoL in incontinent patients, the MUS procedure effectively improved the QoL regardless of these factors. CONCLUSIONS: Preoperative I-QoL assessment revealed a significant impairment of QoL in incontinent women, but the MUS procedure effectively improved these women's QoL.
RESUMO
OBJECTIVE: To evaluate the long-term results and predictive risk factors for efficacy after the tension-free vaginal tape (TVT) procedure for treating female stress urinary incontinence (SUI). PATIENTS AND METHODS: Inall, 306 women (mean age 50.7 years, sd 8.7) who had a TVT procedure for SUI were selected and followed >or=7 years (mean 92.3 months, range 84-110) after surgery. We analysed the long-term results, the variables predictive of cure rates, and patient satisfaction. RESULTS: The overall 7-year cure rate was 84.6%, with a satisfaction rate of 69.3%. The cure rates were lower in patients with high-grade SUI (50% in grade III, 82.8% in grade II and 90.7% in grade I; P < 0.001). On multivariate analysis, there were no independent risk factors related to cure rate, and urgency was the only factor independently associated with patient satisfaction (P = 0.008; odds ratio 2.47). Seventy-one patients (23.2%) had complications at the 1-month follow-up after surgery, but only eight (2.6%) had complications at the 7-year follow-up, including mesh exposure in six and de novo urgency in two. CONCLUSION: The absence of long-term adverse events associated with the TVT procedure, and high subjective and objective 7-year success rates with no independent predictive factors affecting the long-term cure rate, make the TVT procedure a recommendable surgical treatment for female SUI.
