title: The effect of age on stress and urgency urinary incontinence outcomes in women undergoing primary midurethral sling.
abstract: OBJECTIVE
  The primary aim was to characterize stress urinary incontinence (SUI) symptom distress and impact after a midurethral sling (MUS) in women ≥70 compared to women <70 years of age.
  
  
  METHODS
  A retrospective cohort study of women undergoing a primary MUS was conducted. The primary outcome was SUI symptoms defined as either "moderately" or "quite a bit" responses to ≥1 of the two SUI questions of the Pelvic Floor Distress Inventory-20 (PFDI-20). Urgency urinary incontinence (UUI) was defined as either moderately or quite a bit responses to the UUI question of the PFDI-20. The Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Satisfaction Questionnaire (PSQ), and Patient Global Impression of Improvement (PGI-I) questionnaires were also administered.
  
  
  RESULTS
  The mean age of patients ≥70 years (n = 160) was 75.4 ± 4.5 and <70 years (n = 536) was 56.2 ± 9.4. Multivariable analysis revealed no difference in SUI failure rates in older compared to younger cohorts, adjusted odds ratio (OR) 1.7, 95 % confidence interval (CI) 0.9-3.1. Women <70 demonstrated greater improvement in urinary incontinence (UI) symptom impact [-20.4 (33.0) vs -12.2 (30.7), p = 0.01] and women ≥70 had greater persistent UUI symptoms (31.5 vs 23.3 %, p = 0.04); there was no difference between cohorts in resolution of UUI (29.6 vs 34.2 %, p = 0.34). Younger women reported a greater impression of improvement compared to older women (67.7 vs 56.6 %, p = 0.01, respectively).
  
  
  CONCLUSIONS
  Older and younger women have similar SUI outcomes after MUS; however, older women have more persistent UUI and a worse impression of improvement of their urinary tract condition.
authors.affiliation: Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Suite 10382, Birmingham, AL, 35233, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Malek
authors.forename: David R
authors.initials: DR
authors.lastname: Ellington
authors.forename: Victoria
authors.initials: V
authors.lastname: Jauk
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Szychowski
authors.forename: Alison M
authors.initials: AM
authors.lastname: Parden
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D010549:Personal Satisfaction; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D053202:Urinary Incontinence, Urge / Q000601:surgery*