title: Evaluating the results of stress urinary incontinence surgery with objective and subjective outcome measures.
abstract: OBJECTIVE
  To assess the outcomes of stress urinary incontinence (SUI) surgery using objective and subjective measures in women with pure SUI and mixed urinary incontinence (MUI). The degree of correlation between the different outcome measures was also evaluated for both groups.
  
  
  METHODS
  A multicentre prospective cohort study of women who underwent surgery for SUI. A standardized cough stress test was used as the objective outcome measure, and specific items of the Epidemiology of Prolapse and Incontinence Questionnaire were used as the subjective outcome measure. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the Patient Global Impression of Improvement (PGI-I) questionnaires were used for global assessment. Kappa test was used to measure the degree of correlation between the outcome measures.
  
  
  RESULTS
  The participants were categorized into two groups before surgery: pure SUI (n=116) and MUI (n=161). Six months after surgery, the cure rate of the SUI component was high in both groups according to the objective and subjective outcome measures. Global assessment showed lower cure rates. The degree of agreement between objective and subjective outcome measures was moderate (kappa 0.541, p<0.001) for women with pure SUI, and fair (kappa 0.377, p<0.001) for women with MUI. Correlation between the change in ICIQ-UI SF score (pre to post surgery) and the degree of satisfaction (PGI-I) was significant (p<0.01) for both the pure SUI group (0.43) and the MUI group (0.48).
  
  
  CONCLUSIONS
  Both objective and subjective cure rates are high for women with pure SUI and MUI following SUI surgery in Spain. The degree of agreement between different outcome measures varies.
authors.affiliation: Department of Obstetrics and Gynaecology, Donostia Hospital, San Sebastián, Guipúzcoa, Spain. Electronic address: idiezi@sego.es.
authors.forename: I
authors.initials: I
authors.lastname: Diez-Itza
authors.affiliation: Clinical Institute of Gynaecology, Obstetrics and Neonatology, Hospital Clinic I Provincial, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Espuña-Pons
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003371:Cough; D005260:Female; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures
keywords: Outcome measures; Stress urinary incontinence; Surgery