title: The effectiveness of urinary incontinence treatments measured using the 15D Health-Related Quality of Life instrument.
abstract: OBJECTIVE
  The health-related quality of life (HRQoL) is significantly impaired among urinary incontinent women and the effectiveness of urinary incontinence (UI) treatment should be measured using an HRQoL instrument.
  
  
  METHODS
  A prospective, observational study evaluating the HRQoL of 178 non-selected UI patients referred for routine treatment at the Helsinki University Central Hospital between the years 2004 and 2010. HRQoL was assessed using the generic 15D questionnaire on four occasions: before treatment, 6 and 18 months after treatment, and after a median follow-up of 5 years. The HRQoL of the patients was compared with that of an age-standardized Finnish female population.
  
  
  RESULTS
  Compared with the general population, the baseline total HRQoL score of the patients was significantly impaired (p < 0.001). It was worse among the urge or mixed (UUI (±SUI)) incontinence patients than among the stress incontinence (SUI) patients (p = 0.035). During follow-up, HRQoL improved and the improvement was more substantial among the operatively than among the conservatively treated patients (p = 0.027). Statistically significant improvement was only seen in the SUI group (Δ + 0.021, 95 % CI 0.005-0.036), but clinically relevant improvement was also found in the operatively treated UUI (±SUI) group. The maximum benefit of treatment was reached between at 2 and 3 years.
  
  
  CONCLUSIONS
  15D is a sensitive tool for monitoring the change in HRQoL and could be implemented into clinical practice. Operative treatment of UI is effective when measured by improved HRQoL. Not only SUI patients, but also selected patients with an urgency component may benefit from surgery.
authors.affiliation: Department of Gynecology and Pediatrics, Helsinki University Central Hospital HUCH, P.O. Box 140, 00029, Helsinki, Finland, aura.pyykonen@helsinki.fi.
authors.forename: Aura
authors.initials: A
authors.lastname: Pyykönen
authors.forename: Pasi
authors.initials: P
authors.lastname: Aronen
authors.forename: Pirjo
authors.initials: P
authors.lastname: Räsänen
authors.forename: Risto P
authors.initials: RP
authors.lastname: Roine
authors.forename: Jari
authors.initials: J
authors.lastname: Sjöberg
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Tapper
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000628:therapy*; D053202:Urinary Incontinence, Urge / Q000628:therapy*