Medium-term follow-up of transvaginal suburethral slings: variance in outcome success using two different evaluation methods.
OBJECTIVE
To compare Groutz-Blaivas' Simplified Urinary Incontinence Outcome Score (SUIOS) with retrospective chart review for medium-term evaluation of transvaginal suburethral slings.


METHODS
A total of 127 consecutive women underwent transvaginal suburethral sling surgery using In-fast bone screw technology, with a fascia lata graft, from April 1997 to September 1998 (30-month follow-up), performed by a single method. Retrospective evaluation of the patients' office charts was compared with the outcome data determined by the previously validated SUIOS.


RESULTS
Of the 107 available patients, 65 (61%) responded. When evaluating the patients' charts retrospectively, we obtained a complete cure of urinary stress incontinence in 59 (91%), improvement in 3 (4.5%), and complete failure in 3 (4.5%) of the 65 women. Of the 65 patients, 9 (13.5%) reported urge incontinence. The overall urge de novo rate was 9% (6 of 65). On the basis of the SUIOS, 24 (37%) were cured, 22 (34%) had good results, and 10 (15%) of the 65 women had a fair response. By SUIOS, 21 (60%) of 35 patients with mixed incontinence continued having urge incontinence episodes postoperatively compared with 16 (53%) of 30 patients without documented preoperative urge incontinence who developed de novo urge incontinence postoperatively (P <0.05).


CONCLUSIONS
Despite extensive preoperative counseling, patients perceive any kind of postoperative urinary incontinence as a poor outcome. However, we, as physicians, regard success as cure of the stress component when the surgical intervention is concerned. A validated simplified urinary incontinence score represents a more objective account of the outcome.
Franco
Nicholas
N
Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Shobeiri
S Abbas
SA
Echols
Karolynn T
KT
D001294:Attitude to Health; D001863:Bone Screws; D005206:Fascia Lata / Q000601:surgery / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods; D017060:Patient Satisfaction; D011630:Pubic Bone / Q000601:surgery; D012189:Retrospective Studies; D013523:Surgical Equipment; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods / Q000523:psychology; D014621:Vagina / Q000601:surgery