title: Patient satisfaction after midurethral sling surgery for stress urinary incontinence.
abstract: OBJECTIVE
  To identify factors that may contribute to patient satisfaction with outcome in women who received retropubic and transobturator midurethral slings.
  
  
  METHODS
  Satisfaction was assessed 12 months postsurgery as a planned analysis in 597 participants from a multicenter randomized trial comparing retropubic with transobturator midurethral slings using the Incontinence Surgery Satisfaction Questionnaire. Significantly related variables associated with satisfaction in univariable analyses were entered into multivariable logistic regression models to test their independent association with satisfaction.
  
  
  RESULTS
  One year after surgery, 264 (88.6%) in the retropubic group and 263 (88.0%) in the transobturator group completed satisfaction questionnaires. Both treatment groups demonstrated a high level of satisfaction with respect to urine leakage (retropubic 85.9% compared with transobturator 90.0%; P=.52), urgency to urinate, frequency of urination, capability of physical activity, social activity, ability to engage in sexual activity, and from an emotional standpoint. Baseline characteristics associated with reduced satisfaction were higher Medical, Epidemiologic, and Social Aspects of Aging Questionnaire urgency subscale scores, detrusor overactivity, and diabetes mellitus. The severity of both objective (frequency of incontinence episodes, pad test weight) and subjective (Incontinence Impact Questionnaire and Urogenital Distress Inventory score) measures of incontinence at baseline and the patients' perceptions of preoperative severity of incontinence and expectations of achieving postoperative cure or improvement were not statistically different between satisfied and unsatisfied patients. In the final multivariable model, satisfaction was associated with overall treatment success (odds ratio [OR] 2.57, 95% confidence interval [CI] 1.29-5.13], greater reduction in Urogenital Distress Inventory (OR 0.97, 95% CI 0.96-0.98) and Incontinence Impact Questionnaire scores (OR 0.99, 95% CI 0.98-0.99), and fewer complications (OR 0.55, 95% CI 0.30-0.99).
  
  
  CONCLUSIONS
  The high level of satisfaction seen after midurethral sling procedures is associated with greater objective and patient-perceived improvement of stress incontinence and fewer complications.
  
  
  BACKGROUND
  ClinicalTrials.gov, www.clinicaltrials.gov, NCT00325039.
  
  
  METHODS
  II.
authors: University of Texas Southwestern, Dallas, Texas; the New England Research Institutes, Watertown, Massachusetts; the University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Veterans Affairs and The University of Alabama at Birmingham, Birmingham, Alabama; Loyola University Stritch School of Medicine, Chicago, Illinois; the University of Maryland, Baltimore, Maryland; and the University of California, San Diego, California.
authors: Clifford Y
authors: CY
authors: Wai
authors: Teresa M
authors: TM
authors: Curto
authors: Halina M
authors: HM
authors: Zyczynski
authors: Anne M
authors: AM
authors: Stoddard
authors: Kathryn L
authors: KL
authors: Burgio
authors: Linda
authors: L
authors: Brubaker
authors: Leslie M
authors: LM
authors: Rickey
authors: Shawn A
authors: SA
authors: Menefee
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000601:surgery*
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