Female stress urinary incontinence: how do patient and physician perspectives correlate in assessment of outcomes?
OBJECTIVE
This article discusses outcome assessment following surgery for incontinence, by correlating patient perspectives with that of the physician.


RESULTS
A review of the literature demonstrates a large variance in the 'success rates' published for different stress urinary incontinence procedures. We review the elements essential in formation of a universal and valid incontinence questionnaire. Studies have attempted to correlate common clinical measures (voiding diaries, pad testing, urodynamics) with quality-of-life questionnaires. Sentinel articles in incontinence outcome assessment are discussed. Studies with critical measures of outcome are examined using the recommendations made by the Female Stress Urinary Incontinence Guidelines Panel summary report. Through presentation of our data on tension-free vaginal tape procedures, we give insight into the future of stress urinary incontinence research and outcomes.


CONCLUSIONS
Early 'cure rates' were severely limited by their retrospective nature and focus on chart review and physician assessment. Symptom and quality-of-life questionnaires provide subjective outcome assessments. No direct correlation exists between universally accepted objective and subjective measures of improvement. Recent studies are getting closer to the female stress urinary incontinence guidelines. Yet, the pursuit for a universal definition of success continues, in order to bridge patient and physician perspectives on cure.
Padmanabhan
Priya
P
Department of Urology, New York University School of Medicine, New York, New York 10016, USA.
Nitti
Victor W
VW
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017063:Outcome Assessment, Health Care; D010361:Patients / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000523:psychology / Q000601:surgery*