title: Patient-perceived outcomes in the treatment of stress urinary incontinence: focus on urethral injection therapy.
abstract: Intervention for stress urinary incontinence (SUI) is generally focused on minimizing urinary leakage. However, the overall impact of SUI therapy on patients' quality of life is, arguably, more important than leakage outcomes. We performed a literature search to investigate the effect of urethral injection therapy on quality of life. Significant quality-of-life improvements have been observed with a number of injectable agents, while there is a distinct lack of correlation between subjective and objective outcomes. Two studies comparing urethral injection therapy with surgical intervention found superior objective efficacy with surgery, but no significant differences in quality-of-life improvements. Personal goals of patients undergoing urethral injection are yet to be explored, but there may be willingness to trade a lower success rate in favor of a more minor treatment procedure. In conclusion, quality-of-life improvements after urethral injection appear significant and comparable to those obtained with surgery. Further study of patients' own perceptions, pre- and posttreatment, would be valuable.
authors.affiliation: Urology Research Department, J Floor, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK. c.r.chapple@sheffield.ac.uk
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Chapple
authors.forename: Linda
authors.initials: L
authors.lastname: Brubaker
authors.forename: François
authors.initials: F
authors.lastname: Haab
authors.forename: Philip
authors.initials: P
authors.lastname: van Kerrebroeck
authors.forename: Dudley
authors.initials: D
authors.lastname: Robinson
mesh_terms: D003094:Collagen / Q000008:administration & dosage* / Q000009:adverse effects; D003911:Dextrans / Q000008:administration & dosage* / Q000009:adverse effects; D004129:Dimethylpolysiloxanes / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D007267:Injections; D017060:Patient Satisfaction; D011788:Quality of Life; D012828:Silicones / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014521:Urethra / Q000473:pathology*; D014550:Urinary Incontinence, Stress / Q000628:therapy*
chemical_list: D003911:Dextrans; D004129:Dimethylpolysiloxanes; C075314:GAX-collagen; C496587:NASHA-Dx copolymer; D012828:Silicones; C013830:baysilon; D006820:Hyaluronic Acid; D003094:Collagen