The primary aim of this study was to determine what women perceive as ‘cure’ and to assess treatment acceptability. The secondary aim was to identify any relationship between symptom severity and treatment expectations.
Women were recruited prospectively from a tertiary referral urodynamic clinic. All complained of troublesome lower urinary tract symptoms and had been referred for further investigation. Prior to urodynamic studies assessment of lower urinary tract symptoms was performed using the King's Health Questionnaire while subjective assessment of expectations regarding ‘cure’ was performed using a specially designed questionnaire based on structured qualitative clinical interviews. This questionnaire included questions relating to what symptoms patients would find acceptable following treatment, what treatments they would find acceptable, and what their overall expectations were.
One hundred consecutive women were recruited. Mean age was 47.5 years (range: 20–73 years) and mean duration of symptoms 6.0 years (range: 6 mths–40 years). Results concerning overall expectations of treatment, acceptability of symptoms and acceptability of treatments were analyzed. Overall 43% of women hoped for a good improvement in urinary symptoms so there was less effect on their quality of life. The majority of women would find large or frequent episodes of urinary leakage, nocturia, urgency and urge incontinence unacceptable. Minor surgery was more popular than major procedures. There was no correlation between quality of life score and acceptability of symptoms (r = −0.031; P = 0.756) or quality of life scoring and acceptability of treatment (r = 0.127; P = 0.245). Sub group analysis by urodynamic diagnosis and duration of symptoms did not alter the findings.
The majority of women have realistic expectations regarding outcome and are able to tolerate the inconvenience of minor lower urinary tract symptoms. There is no correlation between quality of life impairment and concept of cure implying that expectations of treatment are not influenced by symptom severity.