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Condition-Specific Quality of Life 24 Months After Retropubic and Transobturator Sling Surgery for Stress Urinary Incontinence

Sirls, Larry T. MD; Tennstedt, Sharon PhD; Lukacz, Emily MD; Rickey, Leslie MD; Kraus, Stephen R. MD; Markland, Alayne D. DO; Kenton, Kimberly MD, MS; Moalli, Pam MD; Hsu, Yvonne MD; Huang, Liyuan MSc; Stoddard, Anne M. ScD

Female Pelvic Medicine & Reconstructive Surgery: September/October 2012 - Volume 18 - Issue 5 - p 291–295
doi: 10.1097/SPV.0b013e318267c004
Original Articles

Aims To compare quality of life (QoL) and factors associated with QoL change after retropubic (RMUS) and transobturator midurethral slings (TMUS) using the Incontinence Impact Questionnaire (IIQ) and the International Consultation on Incontinence Questionnaire (ICIQ).

Methods Five hundred ninety-seven women in a multicenter randomized trial of RMUS versus TMUS were examined. The IIQ and the ICIQ were obtained at baseline and at 12 and 24 months. Repeated-measures analysis of variance tested for differences by treatment group over time. Multivariable analysis identified factors associated with QoL change at 12 months postoperative, controlling for treatment group and baseline QoL.

Results Improvement in IIQ was associated with the following: treatment success, younger age, improvement in stress urinary incontinence (SUI) symptom severity, and bother (all P < 0.05). Improvement in ICIQ was associated with treatment success, younger age, improvement in SUI symptom severity and bother, lower body mass index, and no reoperation (all P < 0.05). Improvement of the IIQ was stable over time (P = 0.35) for both treatment groups (P = 0.66), whereas the ICIQ showed a small but clinically insignificant decline (P = 0.03) in both treatment groups (P = 0.51).

Conclusions Postoperative QoL was improved after RMUS and TMUS. Measures of QoL functioned similarly, although more surgically modifiable urinary incontinence factors predicted improvement with the IIQ.

Postoperative QoL is improved after both RP and TO midurethral sling procedures, the IIQ and ICIQ functioned similarly, although more surgically modifiable SUI factors predicted improvement with the IIQ.

From the *Department of Urology, William Beaumont Hospital, Royal Oak, MI; †New England Research Institutes, Watertown, MA; ‡Department of Urology, University of California at San Diego, San Diego, CA; §Department of Urology, University of Maryland, Baltimore, MD; ∥Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX; ¶Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; #Departments of Obstetrics and Gynecology, and Urology, Loyola University Stritch School of Medicine, Maywood, IL; **Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA; and ††Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT.

Reprints: Larry T. Sirls, MD, 31157 Woodward Ave, Royal Oak, MI 48073. E-mail:

This work was 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.

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