title: Surgical preparation: are patients "ready" for stress urinary incontinence surgery?
abstract: OBJECTIVE
  Patient preparedness for stress urinary incontinence (SUI) surgery is associated with improvements in post-operative satisfaction, symptoms and quality of life (QoL). This planned secondary analysis examined the association of patient preparedness with surgical outcomes, treatment satisfaction and quality of life.
  
  
  METHODS
  The ValUE trial compared the effect of pre-operative urodynamic studies with a standardized office evaluation of outcomes of SUI surgery at 1 year. In addition to primary and secondary outcome measures, patient satisfaction with treatment was measured using a five-point Likert scale (very dissatisfied to very satisfied) that queried subjects to rate the treatment's effect on overall incontinence, urge incontinence, SUI, and frequency. Preparedness for surgery was assessed using an 11-question Patient Preparedness Questionnaire (PPQ).
  
  
  RESULTS
  Based on PPQ question 11, 4 out of 5 (81 %) of women reported they "agreed" or "strongly agreed" that they were prepared for surgery. Selected demographic and clinical characteristics were similar in unprepared and prepared women. Among SUI severity baseline measures, total UDI score was significantly but weakly associated with preparedness (question 11 of the PPQ; Spearman's r = 0.13, p = 0.001). Although preparedness for surgery was not associated with successful outcomes, it was associated with satisfaction (r s = 0.11, p = 0.02) and larger PGI-S improvement (increase; p = 0.008).
  
  
  CONCLUSIONS
  Approximately half (48 %) of women "strongly agreed" that they felt prepared for SUI. Women with higher pre-operative preparedness scores were more satisfied, although surgical outcomes did not differ.
authors.affiliation: Departments of OG and Urology, Loyola University Chicago, Stritch School of Medicine, 2160 South First Avenue, Maywood, Chicago, IL, 60153, USA, Lbrubaker@lumc.edu.
authors.forename: L
authors.initials: L
authors.lastname: Brubaker
authors.forename: H J
authors.initials: HJ
authors.lastname: Litman
authors.forename: L
authors.initials: L
authors.lastname: Rickey
authors.forename: K Y
authors.initials: KY
authors.lastname: Dyer
authors.forename: A D
authors.initials: AD
authors.lastname: Markland
authors.forename: L
authors.initials: L
authors.lastname: Sirls
authors.forename: P
authors.initials: P
authors.lastname: Norton
authors.forename: E
authors.initials: E
authors.lastname: Casiano
authors.forename: M F R
authors.initials: MF
authors.lastname: Paraiso
authors.forename: C
authors.initials: C
authors.lastname: Ghetti
authors.forename: D D
authors.initials: DD
authors.lastname: Rahn
authors.forename: J W
authors.initials: JW
authors.lastname: Kusek
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011300:Preoperative Care / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*
references.citation: Contemp Clin Trials. 2009 Nov;30(6):531-9
references.pmid: 19635587
references.citation: Am J Obstet Gynecol. 2007 Dec;197(6):654.e1-6
references.pmid: 18060968
references.citation: J Am Coll Surg. 2012 May;214(5):816-21.e2
references.pmid: 22464659
references.citation: Br J Ophthalmol. 2005 Jan;89(1):10-3
references.pmid: 15615737
references.citation: Am J Obstet Gynecol. 2009 Jan;200(1):88.e1-5
references.pmid: 18845285
references.citation: Health Aff (Millwood). 2013 Feb;32(2):393-400
references.pmid: 23381533
references.citation: Am J Obstet Gynecol. 2003 Dec;189(6):1551-7; discussion 1557-8
references.pmid: 14710061
references.citation: Am J Obstet Gynecol. 2011 May;204(5):444.e1-6
references.pmid: 21349492
references.citation: BJOG. 2010 Nov;117(12):1504-11
references.pmid: 20937072
references.citation: Am J Obstet Gynecol. 2006 Mar;194(3):722-8
references.pmid: 16522404
references.citation: N Engl J Med. 2012 May 24;366(21):1987-97
references.pmid: 22551104
references.citation: J Urol. 2008 Mar;179(3):1024-30
references.pmid: 18206917
references.citation: Am J Obstet Gynecol. 2004 Jul;191(1):201-5
references.pmid: 15295366