Top

Health and Quality of Life Outcomes

Published in:

Open Access 01-12-2009 | Review

Distress and quality of life characteristics associated with seeking surgical treatment for stress urinary incontinence

Authors: Karen M Gil, Amber M Somerville, Sara Cichowski, Jennifer L Savitski

Published in: Health and Quality of Life Outcomes | Issue 1/2009

Abstract

Background

Current research focuses on three variables in evaluating the impact of stress urinary incontinence (SUI) on daily living: severity of incontinence, distress or bother resulting from incontinence, and effect on health related quality of life (HRQoL). Understanding the impact of these variables is important as they are the driving force behind women seeking surgical treatment. Given the importance of HRQoL in determining need for treatment, as well as evaluating treatment success, this review provides an assessment of the degree to which HRQoL is impaired in women seeking surgical treatment.

Methods

PubMed searches for the terms "quality of life and distress and urinary incontinence" and "quality of life and bother and urinary incontinence" were performed with limits of English, human and female subjects through May 2008. All studies using validated instruments were included. No time limit was placed on the search.

Results

Of 178 articles retrieved, 21 met the inclusion criteria, and 17 reported methods of scoring. The studies used the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). Wide ranges of mean and individual levels of severity of symptoms, UDI and IIQ scores were seen among women seeking surgical treatment. Fourteen studies reported baseline and post-surgical treatment distress and QoL data. Statistically significant improvements between baseline and post-surgical UDI and IIQ scores were reported in 12 studies. Reported cure rates ranged from 46% to 97%. Satisfaction with the procedure was reported in 4 studies and ranged from 84% to 91%. A minority of studies reported the relationship between reduction in symptoms and change in HRQoL.

Conclusion

HRQoL is the main reason women seek surgical treatment for incontinence and surgical treatment leads to a significant improvement in mean HRQoL scores. Assessment of HRQoL has proved less useful in identifying why individual women seek treatment for incontinence. Preliminary work has begun to characterize the interaction between severity of symptoms, distress or bother resulting from these urinary symptoms, impact on HRQoL, and treatment seeking behavior, but further research is needed. Greater standardization in the reporting of results of distress or bother and HRQoL would allow for comparison across studies.

Available only for authorised users

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Vicor A, Wein A: The standardization of terminology of lower urinary tract function: Report from the Standardization Sub-committee of the International Continence Society. Am J Obstet Gynecol 2002, 187: 116–26. 10.1067/mob.2002.125704CrossRef

Vaart CH, De Leeuw JRJ, Roovers JPWR, Heintz APM: The effect of urinary incontinence and overactive bladder symptoms on quality of life in young women. BJU International 2002, 90: 544–549. 10.1046/j.1464-410X.2002.02963.xCrossRef

Robinson D, Pearce KF, Preisser JS, Dugan E, Suggs PK, Cohen SJ: Relationship between patient reports of urinary incontinence symptoms and quality of life measures. Obstet Gynecol 1998, 91: 224–228. 10.1016/S0029-7844(97)00627-3CrossRef

Lin SY, Dougherty MC: Incontinence impact, symptom distress and treatment-seeking behavior in women with involuntary urine loss in Southern Taiwan. Int J Nursing Studies 2003, 40: 227–234. 10.1016/S0020-7489(02)00081-0CrossRef

Fultz NH, Burgio K, Diokno AC, Kinchen KS, Obenchain R, Bump RC: Burden of stress urinary incontinence for community-dwelling women. Am J Obstet Gynecol 2003, 189: 1275–82. 10.1067/S0002-9378(03)00598-2CrossRef

Papanicolaou S, Hunskaar S, Lose G, Sykes D: Assessment of bothersomeness and impact on quality of life of urinary incontinence in women in France, Germany, Spain, and the UK. BJU International 2005, 96: 831–838. 10.1111/j.1464-410X.2005.05722.xCrossRef

Goldberg RP, Kwon C, Gandhi S, Atkuru LV, Sand PK: Urinary incontinence after multiple gestation and delivery: impact on quality of life. Int Urogynecol J 2005, 16: 334–336. 10.1007/s00192-004-1252-7CrossRef

Monz B, Chartier-Kastler E, Hampel C, Samsioe G, Hunskaar S, Espuna-Pons M, Wagg A, Quail D, Castro R, Chinn C: Patient characteristics associated with quality of life in European women seeking treatment for urinary incontinence: results from PURE. Eur Urol 2007,51(4):1073–81. 10.1016/j.eururo.2006.09.022CrossRef

Norton P, Brubaker L: Urinary incontinence in women. The Lancet 2006, 367: 57–67. 10.1016/S0140-6736(06)67925-7CrossRef

10.

Thom D: Variation in estimates of urinary incontinence prevalence in the community: effects of differences in definition, population characteristics, and study type. JAGS 1998, 46: 473–480.CrossRef

11.

Minassian VA, Drutz HP, Al-Badr A: Urinary incontinence as a worldwide problem. Int J Obstet Gynecol 2003, 82: 327–338. 10.1016/S0020-7292(03)00220-0CrossRef

12.

Martin JL, Williams KS, Abrams KR, Turner DA, Sutton AJ, Chapple C, Assassa RP, Shaw C, Cheater F: Systematic review and evaluation of methods of assessing urinary incontinence. Health Technol Assess 2006,10(6):1–132.CrossRef

13.

Murphy BA, Ridner S, Wells N, Dietrich M: Quality of life research in head and neck cancer: A review of the current state of the science. Crit Rev Oncology/Hematology 2007, 62: 251–267. 10.1016/j.critrevonc.2006.07.005CrossRef

14.

Penson RT, Wenzel LB, Vergote I, Cella D: Quality of life considerations in gynecologic cancer. Int J Gynaecol Obstet 2006,95(Suppl 1):S247–57. 10.1016/S0020-7292(06)60040-4CrossRef

15.

Avery KN, Bosch JL, Gotoh M, Naughton M, Jackson S, Radley SC, Valiquette L, Batista J, Donovan JL: Questionnaires to assess urinary and anal incontinence: review and recommendations. J Urol 2007,177(1):39–49. 10.1016/j.juro.2006.08.075CrossRef

16.

Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P: ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 2004,23(4):322–30. 10.1002/nau.20041CrossRef

17.

Brookes ST, Donovan JL, Wright M, Jackson S, Abrams P: A scored form of the Bristol Female Lower Urinary Tract Symptoms questionnaire: data from a randomized controlled trial of surgery for women with stress incontinence. Am J Obstet Gynecol 2004,191(1):73–82. 10.1016/j.ajog.2003.12.027CrossRef

18.

Kulseng-Hanssen S, Borstad E: The development of a questionnaire to measure the severity of symptoms and the quality of life before and after surgery for stress incontinence. BJOG 2003,110(11):983–8. 10.1111/j.1471-0528.2003.01406.xCrossRef

19.

Shumaker SA, Wyman JF, Uebersax JS, McClish D, Fantl JA: Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program in Women (CPW) Research Group. Qual Life Res 1994,3(5):291–306. 10.1007/BF00451721CrossRef

20.

Uebersax JS, Wyman JF, Shumaker SA, McClish D, Fantl JA: Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourol Urodyn 1995,14(2):131–9. 10.1002/nau.1930140206CrossRef

21.

Sandvik H, Seim A, Vanvik A, Hunskaar S: A severity index for epidemiological surveys of female urinary incontinence: comparison with 48-hour pad-weighing tests. Neurourol Urodyn 2000,19(2):137–45. 10.1002/(SICI)1520-6777(2000)19:2<137::AID-NAU4>3.0.CO;2-GCrossRef

22.

Jackson S, Donovan J, Brookes S, Eckford S, Swithinbank L, Abrams P: The Bristol Female Lower Urinary Tract Symptoms questionnaire: development andpsychometric testing. Br J Urol 1996,77(6):805–12.CrossRef

23.

Patrick DL, Martin ML, Bushnell DM, Yalcin I, Wagner TH, Buesching DP: Quality of life of women with urinary incontinence: further development of the incontinence quality of life instrument (I-QOL). Urology 1999,53(1):71–6. 10.1016/S0090-4295(98)00454-3CrossRef

24.

Stothers L: Reliability, validity, and gender differences in the quality of life index of the SEAPI-QMM incontinence classification system. Neurourol Urodyn 2004,23(3):223–8. 10.1002/nau.20001CrossRef

25.

Kelleher CJ, Cardozo LD, Khullar V, Salvatore S: A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol 1997,104(12):1374–9.CrossRef

26.

Stach-Lempinen B, Kirkinen P, Laippala P, Metsanoja R, Kujansuu E: Do objective urodynamic or clinical findings determine impact of urinary incontinence or its treatment on quality of life? Urology 2004, 63: 67–71. 10.1016/j.urology.2003.07.022CrossRef

27.

Amarenco G, Arnould B, Carita P, Haab F, Labat JJ, Richard F: European psychometric validation of the CONTILIFE: a Quality of Life questionnaire for urinary incontinence. Eur Urol 2003,43(4):391–404. 10.1016/S0302-2838(03)00054-XCrossRef

28.

Sandvik H, Espuna M, Hunskaar S: Validity of the incontinence severity index: comparison with pad-weighing tests. Int Urogynecol J Pelvic Floor Dysfunct 2006,17(5):520–4. 10.1007/s00192-005-0060-zCrossRef

29.

Diokno AC, Dimaculangan RR, Lim EU, Steinert BW: Office based criteria for predicting type II stress incontinence without further evaluation studies. J Urol 1999, 161: 1263–7. 10.1016/S0022-5347(01)61652-5CrossRef

30.

Elser DM, Fantl JA, McClish DK: Comparison of "subjective" and "objective" measures of severity of urinary incontinence in women. Program for Women Research Group. Neurourol Urodyn 1995,14(4):311–6. 10.1002/nau.1930140403CrossRef

31.

Rogers RG: Clinical practice. Urinary stress incontinence in women. N Engl J Med 2008,358(10):1029–36. 10.1056/NEJMcp0707023CrossRef

32.

Wyman JF, Choi SC, Harkins SW, Wilson MS, Fantl JA: The urinary diary in evaluation of incontinent women: a test-retest analysis. Obstet Gynecol 1988,71(6 Pt 1):812–7.

33.

Ryhammer AM, Djurhuus JC, Laurberg S: Pad testing in incontinent women: a review. Int Urogynecol J Pelvic Floor Dysfunct 1999,10(2):111–5. 10.1007/s001920050028CrossRef

34.

Burgio KL, Locher JL, Goode PS, Hardin JM, McDowell BJ, Dombrowski M, Candib D: Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trial. JAMA 1998,280(23):1995–2000. 10.1001/jama.280.23.1995CrossRef

35.

Vaart C, de Leeuw JRJ, Roovers JPWR, Heintz APM: Measuring health-related quality of life in women with urogenital dysfunction: The Urogenital Distress Inventory and Incontinence Impact Questionnaire revisited. Neurourol Urodyn 2003, 22: 97–104. 10.1002/nau.10038CrossRef

36.

Porena M, Costantini E, Frea B, Giannantoni A, Ranzoni S, Mearini L, Bini V, Kocjancic E: Tension-free vaginal tape versus transobturator tape as surgery for stress urinary incontinence: results of a multicentre randomised trial. Eur Urol 2007,52(5):1481–90. 10.1016/j.eururo.2007.04.059CrossRef

37.

Laurikainen E, Valpas A, Kivela A, Kalliola T, Rinne K, Takala R, Nilsson CG: Retropubic compared with transobturator tape placement in treatment of urinary incontinence – a randomized controlled trial. Obstet Gynecol 2007, 109: 4–11.CrossRef

38.

Juma S, Brito CG: Transobturator tape: two years follow-up. Neurourol Urodyn 2007, 26: 37–41. 10.1002/nau.20353CrossRef

39.

FitzGerald MP, Kenton K, Shott S, Brubaker L: Responsiveness of quality of life measurements to change after reconstructive pelvic surgery. Am J Obstet Gynecol 2001,185(1):20–4. 10.1067/mob.2001.116364CrossRef

40.

Murphy M, van Raalte H, Mercurio E, Haff R, Wiseman B, Lucente VR: Incontinence-related quality of life and sexual function following the tension-free vaginal tape versus the "inside-out" tension-free vaginal tape obturator. Int Urogynecol J Pelvic Floor Dysfunct 2008,19(4):481–7. 10.1007/s00192-007-0482-xCrossRef

41.

Sung VW, Glasgow MA, Wohlrab KJ, Myers DL: Impact of age on preoperative and postoperative urinary incontinence quality of life. Am J Obstet Gynecol 2007, 197: 680. e1–5.CrossRef

42.

Albo M, Wruck L, Baker J, Brubaker L, Chai T, Dandreo KJ, Diokno A, Goode P, Kraus S, Kusek JW, Lemack G, Lowder J, Steers W, the Urinary Incontinence Treatment Network: The relationships among measures of incontinence severity in women undergoing surgery for stress urinary incontinence. J Urol 2007, 177: 1810–1814. 10.1016/j.juro.2007.01.032CrossRef

43.

Lowenstein L, Dooley Y, Kenton K, Rickey L, FitzGerald MP, Mueller E, Brubaker L: The volume at which women leak first on urodynamic testing is not associated with quality of life, measures of urethral integrity or surgical failure. J Urol 2007, 178: 193–196. 10.1016/j.juro.2007.03.031CrossRef

44.

Domingo S, Alama P, Ruiz N, Lazaro G, Morell M, Pellicer A: Transobturator tape procedure outcome: a clinical and quality of life analysis of a 1-year follow-up. Int Urogynecol J 2007, 18: 895–900. 10.1007/s00192-006-0263-yCrossRef

45.

Bakas P, Liapis A, Giner M, Creatsas G: Quality of life in relation to TVT procedure for the treatment of stress urinary incontinence. Acta Obstetricia et Gynecologia 2006, 85: 748–752.CrossRef

46.

Murphy M, Culligan PJ, Arce CM, Graham CA, Blackwell L, Heit MH: Construct validity of the incontinence severity index. Neurourol Urodyn 2006, 25: 418–423. 10.1002/nau.20246CrossRef

47.

Schraffordt Koops SE, Bisseling TM, Heintz APM, Vervest HAM: Quality of life before and after TVT, a prospective multicentre cohort study, results from the Netherlands TVT database. BJOG 2006, 113: 26–29. 10.1111/j.1471-0528.2005.00809.xCrossRef

48.

Richter HE, Norman AM, Burgio KL, Goode PS, Wright KC, Benton J, Varner RE: Tension-free vaginal tape: a prospective subjective and objective outcome analysis. Int Urogynecol J 2005, 16: 109–113. 10.1007/s00192-004-1238-5CrossRef

49.

Tomoe H, Kondo A, Takei M, Nakata M, Toma H, Tension-free Vaginal Tape Trial Group: Quality of life assessments in women operated on by tension-free vaginal tape (TVT). Int Urogynecol J 2005, 16: 114–118. 10.1007/s00192-004-1231-zCrossRef

50.

Segal JL, Vassallo B, Kleeman S, Silva WA, Karram MM: Prevalence of persistent and de novo overactive bladder symptoms after the tension-free vaginal tape. Obstet Gynecol 2004, 104: 1263–1269.CrossRef

51.

Paraiso MFR, Walters MD, Karram MM, Barber MD: Laparoscopic Burch colposuspension versus tension-free vagincal tape: a randomized trial. Obstet Gynecol 2004, 104: 1249–1258.CrossRef

52.

Crivellaro S, Smith JJ, Kocjancic A, Bresette JF: Transvaginal sling using acellular human dermal allograft: safetly and efficacy in 253 patients. J Urol 2004, 172: 1374–1378. 10.1097/01.ju.0000138460.03758.5eCrossRef

53.

Hung MJ, Liu FS, Shen PS, Chen GD, Lin LY, Ho ESC: Analysis of two sling procedures using polypropylene mesh for treatment of stress urinary incontinence. Int J Gynecol Obstet 2004, 84: 133–141. 10.1016/S0020-7292(03)00345-XCrossRef

54.

Richter HE, Burgio KL, Holley RL, Goode PS, Locher JL, Wright KC, Varner RE: Cadaveric fasica lata sling for stress urinary incontinence: a prospective quality-of-life analysis. Am J Obstet Gynecol 2003, 189: 1590–6. 10.1016/j.ajog.2003.08.016CrossRef

55.

Hagen S, Hanley J, Capewell A: Test-retest reliability, validity, and sensitivity to change of the urogenital distress inventory and the incontinence impact questionnaire. Neurourol Urodyn 2002, 21: 534–539. 10.1002/nau.10075CrossRef

56.

Vassallo BJ, Kleeman SD, Segal JL, Walsh P, Karram MM: Tension-free vaginal tape: a quality of life assessment. Obstet Gynecol 2002, 100: 518–24. 10.1016/S0029-7844(02)02119-1CrossRef

57.

Tennstedt Sl, Fitzgerald MP, Nager CW, Xu Y, Zimmern P, Kraus S, Goode PS, Kusek JW, Borello-France D, Mallett V, (Urinary Incontinence Treatment Network): Quality of life in women with stress urinary incontinence. Int Urogynecol J 2007, 18: 543–549. 10.1007/s00192-006-0188-5CrossRef

58.

Novara G, Ficarra V, Boscolo-Berto R, Secco S, Cavalleri S, Artibani W: Tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials of effectiveness. Eur Urol 2007,52(3):663–78. 10.1016/j.eururo.2007.06.018CrossRef

59.

Albo ME, Richter HE, Brubaker L, Norton P, Kraus SR, Zimmern PE, (Urinary Incontinence Treatment Network), et al.: Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 2007,356(21):2143–55. 10.1056/NEJMoa070416CrossRef

Title: Distress and quality of life characteristics associated with seeking surgical treatment for stress urinary incontinence
Authors: Karen M Gil
Amber M Somerville
Sara Cichowski
Jennifer L Savitski
Publication date: 01-12-2009
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2009
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/1477-7525-7-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Distress and quality of life characteristics associated with seeking surgical treatment for stress urinary incontinence

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2009

Cognitive impairment and preferences for current health

Quality of life in South East Asian patients who consult for dyspepsia: Validation of the short form Nepean Dyspepsia Index

Prospective evaluation of chronic pain associated with posterior autologous iliac crest bone graft harvest and its effect on postoperative outcome

Health-related quality of life in children with cystic fibrosis: validation of the German CFQ-R

Correlations among improvements in urgency urinary incontinence, health-related quality of life, and perception of bladder-related problems in incontinent subjects with overactive bladder treated with tolterodine or placebo

Understanding Ferguson's δ: time to say good-bye?