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Is Complete Cure Necessary For Satisfaction In Patients Undergoing Concurrent Anti-incontinence And Prolapse Surgery?
Jeffrey P Wolters1, Ashley B King1, Adam P Klausner1, David E Rapp2
1Virginia Commonwealth University, Richmond,, VA;2Virginia Urology Center for Incontinence and Pelvic Floor Reconstruction, Richmond,, VA
Introduction: Simultaneous repair of SUI and prolapse has become increasingly common. In these cases, determinants of patient satisfaction are further complicated given the fact that complete surgical success may be achieved in one component but not the other. The study focus was to determine if patients report satisfaction if success is only achieved with respect to a single outcome when concurrent surgeries are performed.
Materials & Methods: We performed a retrospective review of post-operative Results on 92 consecutive women undergoing variety of AI procedures and/or prolapse repair. Multiple validated outcome measures were used to evaluate success following AI surgery (ICIQ-FLUTS, SUI item, pad use, subjective SUI cure) and prolapse (ICIQ-VS, POPQ stage). Multiple statistical analyses (Pearson's correlation, Mann-Whitney, and Fischer's exact) were performed to assess for association between outcome measures and patient satisfaction.
Results: Eighty women (87%) reported satisfaction following surgery with mean follow-up of 12 months. Cure of both prolapse (POPQ stage <2) and SUI (subjective cure) was associated with satisfaction (p<0.05). Satisfaction rates among these dual cure patients were comparable to satisfaction rates in women who had cure of only one entity (prolapse OR incontinence). ICIQ-VS improvement correlated with overall post-op satisfaction (p<0.05) while the other examined measures did not demonstrate statistically significant correlation with post-op satisfaction.
Conclusions: Not surprisingly, cure of both incontinence and prolapse in the setting of a concominant procedure was associated with statistically significant satisfaction. Interestingly, these satisfaction rates do not differ greatly from those in patient's who reported cure of only one problem.
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