title: One hundred cases of SUI treatment that failed: a prospective observational study on the behavior of patients after surgical failure.
abstract: OBJECTIVE
  Determine what happens to patients after unsuccessful SUI operations and to explore the reasons why these patients change doctors.
  
  
  METHODS
  One hundred consecutive failed patients treated for SUI were interviewed about the exams requested after persistence of the incontinence as well as the reasons they abandoned their primary doctors through a structured questionnaire.
  
  
  RESULTS
  Among the patients with cases of anterior colporrhaphy, bladder suspensions or slings, 34.3%, 13.7% and 8.3%, respectively, were not offered any further type of investigative procedures to clarify the failure. Urodynamic evaluations were recommended in 75% of failed slings, and 66.6% of the patients proceeded with these tests. In contrast, only 31% of patients with bladder suspensions and 40% of patients with anterior colporrhaphy were recommended for urodynamic investigations, and only 44.4% and 28.5% of them, respectively, proceeded with the option. Patients' delusions were reinforced by the doctors' attitude toward the investigations. Vacuous justifications and the lack of intention to seek improvement were the driving forces causing the patients to change doctors.
  
  
  CONCLUSIONS
  Unsuccessful patients are evaluated in a non-protocol form. Difficulty in clarifying the reasons for surgical failure and the disruption of the doctor-patient relationship are the main reasons why patients abandon them.
authors.affiliation: Urology Clinic, Hospital Beneficência Portuguesa of São Paulo, São Paulo, Brazil and Urology Department, Hospital Santa Helena of São Paulo, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Rodrigues
authors.affiliation: Urology Clinic, Hospital Beneficência Portuguesa of São Paulo, São Paulo, Brazil and Urology Department, Hospital Santa Helena of São Paulo, São Paulo, Brazil.
authors.forename: Flávio
authors.initials: F
authors.lastname: Hering
authors.affiliation: Urology Clinic, Hospital Beneficência Portuguesa of São Paulo, São Paulo, Brazil.
authors.forename: Márcio
authors.initials: M
authors.lastname: D'Império
authors.affiliation: Urology Department, Hospital Santa Helena of São Paulo, São Paulo, Brazil.
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Campagnari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D017211:Treatment Failure; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods