title: Change in urinary storage symptoms following treatment for female stress urinary incontinence.
abstract: OBJECTIVE
  Sling surgery is common for stress urinary incontinence (SUI). Yet many women have stress-predominant mixed urinary incontinence (MUI). The change in urgency/urge urinary incontinence (U/UUI) following treatment is not well documented. Our aim was to assess changes in U/UUI in women undergoing a sling placement for MUI and correlate this with improvement in quality of life (QOL).
  
  
  METHODS
  This was a retrospective review of women treated for SUI with either an autologous rectus fascia pubovaginal sling (AF-PVS) or synthetic retropubic midurethral sling (MUS). Validated questionnaires-Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), and visual analog scale (VAS) were obtained pre- and postoperatively. The independent association between change in storage symptoms and subjective cure-as defined by improved overall score on UDI-6, VAS score ≥ 7, or both -were assessed using multivariate logistic regression.
  
  
  RESULTS
  Nine hundred and twenty-seven women were identified for inclusion; 718 (77.5 %) had preoperative MUI, of whom 487 (67.8 %) received an MUS and 231 (32.2 %) an AF-PVS. Similar objective cure rates were noted following MUS vs. AF-PVS (78.2 % vs. 71.9 %, p = 0.315). Subjectively, women treated with MUS experienced greater improvement in U/UUI (72.8 % vs. 57.6 %, p = <0.001) than AF-PVS. Multivariate analysis showed MUS patients were more than twice as likely to show subjective improvement in UDI-6 and VAS scores than the AF-PVS cohort. Postoperatively, validated questionnaires were significantly associated with storage symptom outcome.
  
  
  CONCLUSIONS
  Patients with U/UUI experience significant symptom improvement following treatment for MUI. QoL assessment following surgery is directly correlated with improvement in U/UUI.
authors.affiliation: Department of Urology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA. ppadmanabhan@kumc.edu.
authors.forename: Priya
authors.initials: P
authors.lastname: Padmanabhan
authors.affiliation: Department of Urology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Panfili
authors.affiliation: Department of Urology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.
authors.forename: William
authors.initials: W
authors.lastname: Parker
authors.affiliation: Department of Urology, Louisiana State University Health-Shreveport, 1501 Kings Highway, Shreveport, LA, 71130, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Gomelsky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology*; D011788:Quality of Life; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D053202:Urinary Incontinence, Urge / Q000209:etiology / Q000473:pathology*; D055815:Young Adult
keywords: Incontinence; Midurethral sling; Pubovaginal sling; Quality of life