The effect of age on stress and urgency urinary incontinence outcomes in women undergoing primary midurethral sling.

Academic Article

Abstract

  • INTRODUCTION AND HYPOTHESIS: 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.
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    Keywords

  • Age Factors, Aged, Female, Humans, Multivariate Analysis, Personal Satisfaction, Prosthesis Implantation, Retrospective Studies, Suburethral Slings, Treatment Outcome, Urinary Incontinence, Stress, Urinary Incontinence, Urge
  • Digital Object Identifier (doi)

    Author List

  • Malek JM; Ellington DR; Jauk V; Szychowski JM; Parden AM; Richter HE
  • Start Page

  • 831
  • End Page

  • 835
  • Volume

  • 26
  • Issue

  • 6