title: Prospective analysis of patients treated with a distal urethral polypropylene sling for symptoms of stress urinary incontinence: surgical outcome and satisfaction determined by patient driven questionnaires.
abstract: OBJECTIVE
  We evaluated the safety and efficacy of the distal urethral polypropylene sling for stress urinary incontinence using patient self-assessment by questionnaires.
  
  
  METHODS
  We performed a prospective study of all consecutive patients who underwent a mid distal urethral sling procedure between November 1999 and February 2002. Surgical outcome was determined by symptom, bother and quality of life questionnaires completed by the patients. The physicians were blinded to patient responses. These outcomes were compared to the SEAPI determined by the physician and to physical examination findings.
  
  
  RESULTS
  There were 301 patients, of whom 2.3% required treatment for persistent stress urinary incontinence (SUI) after the polypropylene sling procedure. In the 92 patients with a minimum followup of 12 months the objective cure rate was 92%. The patient determined subjective success rate (cure and improved greater than 50%) was 89%. On questionnaires only 69% of the patients reported no symptoms of SUI under any circumstance and the same number reported never being bothered by SUI. The physician determined SEAPI overestimated patient self-reported symptoms by 10% to 50% depending on the symptom.
  
  
  CONCLUSIONS
  The polypropylene sling represents an inexpensive, safe and simple alternative treatment for patients with stress urinary incontinence. The procedure provides high objective and physician determined cure rates but a lower patient self-reported subjective cure rate. Patient self-assessment of symptoms, bother and quality of life should be an integral part of the outcome of stress urinary incontinence surgery.
authors.affiliation: Department of Urology, School of Medicine, University of California-Los Angeles, 924 Westwood Boulevard, Suite 520, Los Angeles, CA 90024, USA.
authors.forename: Larissa V
authors.initials: LV
authors.lastname: Rodríguez
authors.forename: Shlomo
authors.initials: S
authors.lastname: Raz
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011126:Polypropylenes; D011446:Prospective Studies; D019736:Prostheses and Implants; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures
chemical_list: D011126:Polypropylenes