Do pad tests and voiding diaries affect patient willingness to participate in studies of incontinence treatment outcomes?
OBJECTIVE
We used the Simplified Urinary Incontinence Outcome Score (SUIOS) to retrospectively assess the continence outcomes following 107 consecutive autologous rectus fascia pubovaginal sling procedures. This outcome score requires completion of a questionnaire, voiding diary and pad test. The voiding diary and pad test provide objective data but require a degree of patient effort and motivation. We determine if the voiding diary and pad test requirements would significantly reduce the rate of followup.


METHODS
After recruitment letters were mailed to all eligible patients, followup telephone calls were made to ask them to complete the SUIOS protocol. Those who agreed were mailed a packet containing the pre-weighed pads, voiding diary and questionnaire. Patients who refused were asked to complete a telephone questionnaire instead. Patients were given 1 month to complete and return the study materials. If the materials were not returned, repeat telephone reminders were made. If patients were unwilling to complete the protocol at this point, they were offered the option of completing only the questionnaire by telephone. Treatment outcomes were classified according to the SUIOS protocol, and the followup rate for the full protocol was compared with that for the questionnaire only responses.


RESULTS
Of the 107 patients 18 were lost to followup and 10 refused to participate, leaving 79 (74%) evaluable patients. Mean followup interval was 31 months (range 9 to 66). Of the 79 women 38 (48%) completed the questionnaire portion but were unwilling to complete the voiding diary and pad test. The remaining 41 patients (52%) completed the entire protocol. Complete SUIOS scores were 59% cured, 24% good response, 10% fair response, 2% poor response and 5% failure. Questionnaire response results were similar, with 61% cured, 32% improved and 8% failed.


CONCLUSIONS
The majority of our patients were unwilling to complete a pad test and voiding diary for the purpose of assessing outcomes after anti-incontinence surgery. The possible increased accuracy of these outcome measures needs to be weighed against the lower followup rate associated with their use.
Singh
Mandeep
M
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Bushman
Wade
W
Clemens
J Quentin
JQ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016496:Incontinence Pads; D008499:Medical Records; D008875:Middle Aged; D010358:Patient Participation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014554:Urination