Patient related factors associated with long-term urinary continence after burch colposuspension and pubovaginal fascial sling surgeries

Holly E. Richter, Linda Brubaker, Anne M. Stoddard, Yan Xu, Halina M. Zyczynski, Peggy Norton, Larry T. Sirls, Stephen R Kraus, Toby C. Chai, Philippe Zimmern, E. Ann Gormley, John W. Kusek, Michael E. Albo

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose: We examined preoperative and postoperative patient related factors associated with continence status up to 7 years after surgery for stress urinary incontinence. Materials and Methods: Women randomized to Burch colposuspension or fascial sling surgery and assessed for the primary outcome of urinary continence 2 years after surgery were eligible to enroll in a prospective observational study. Survival analysis was used to investigate baseline and postoperative factors in the subsequent risk of stress urinary incontinence, defined as self-report of stress urinary incontinence symptoms, incontinence episodes on a 3-day diary or surgical re-treatment. Results: Of the women who participated in the randomized trial 74% (482 of 655) were enrolled in the followup study. Urinary continence rates decreased during a period of 2 to 7 years postoperatively from 42% to 13% in the Burch group and from 52% to 27% in the sling group, respectively. Among the baseline factors included in the first multivariable model age (p = 0.03), prior stress urinary incontinence surgery (p = 0.02), menopausal status (0.005), urge index (0.006), assigned surgery (p = 0.01) and recruiting site (p = 0.02) were independently associated with increased risk of incontinence. In the final multivariable model including baseline and postoperative factors, Burch surgery (p = 0.01), baseline variables of prior urinary incontinence surgery (p = 0.04), menopausal status (p = 0.03) and postoperative urge index (p <0.001) were each significantly associated with a greater risk of recurrent urinary incontinence. Conclusions: Preoperative and postoperative urgency incontinence symptoms, Burch urethropexy, prior stress urinary incontinence surgery and menopausal status were negatively associated with long-term continence rates. More effective treatment of urgency urinary incontinence in patients who undergo stress urinary incontinence surgery may improve long-term overall continence status.

Original languageEnglish (US)
Pages (from-to)485-489
Number of pages5
JournalJournal of Urology
Volume188
Issue number2
DOIs
StatePublished - Aug 2012
Externally publishedYes

Fingerprint

Stress Urinary Incontinence
Urinary Incontinence
Survival Analysis
Self Report
Observational Studies
Prospective Studies
Therapeutics

Keywords

  • operative
  • stress
  • surgical procedures
  • treatment outcome
  • urge
  • urinary incontinence

ASJC Scopus subject areas

  • Urology

Cite this

Patient related factors associated with long-term urinary continence after burch colposuspension and pubovaginal fascial sling surgeries. / Richter, Holly E.; Brubaker, Linda; Stoddard, Anne M.; Xu, Yan; Zyczynski, Halina M.; Norton, Peggy; Sirls, Larry T.; Kraus, Stephen R; Chai, Toby C.; Zimmern, Philippe; Gormley, E. Ann; Kusek, John W.; Albo, Michael E.

In: Journal of Urology, Vol. 188, No. 2, 08.2012, p. 485-489.

Research output: Contribution to journalArticle

Richter, HE, Brubaker, L, Stoddard, AM, Xu, Y, Zyczynski, HM, Norton, P, Sirls, LT, Kraus, SR, Chai, TC, Zimmern, P, Gormley, EA, Kusek, JW & Albo, ME 2012, 'Patient related factors associated with long-term urinary continence after burch colposuspension and pubovaginal fascial sling surgeries', Journal of Urology, vol. 188, no. 2, pp. 485-489. https://doi.org/10.1016/j.juro.2012.04.010
Richter, Holly E. ; Brubaker, Linda ; Stoddard, Anne M. ; Xu, Yan ; Zyczynski, Halina M. ; Norton, Peggy ; Sirls, Larry T. ; Kraus, Stephen R ; Chai, Toby C. ; Zimmern, Philippe ; Gormley, E. Ann ; Kusek, John W. ; Albo, Michael E. / Patient related factors associated with long-term urinary continence after burch colposuspension and pubovaginal fascial sling surgeries. In: Journal of Urology. 2012 ; Vol. 188, No. 2. pp. 485-489.
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abstract = "Purpose: We examined preoperative and postoperative patient related factors associated with continence status up to 7 years after surgery for stress urinary incontinence. Materials and Methods: Women randomized to Burch colposuspension or fascial sling surgery and assessed for the primary outcome of urinary continence 2 years after surgery were eligible to enroll in a prospective observational study. Survival analysis was used to investigate baseline and postoperative factors in the subsequent risk of stress urinary incontinence, defined as self-report of stress urinary incontinence symptoms, incontinence episodes on a 3-day diary or surgical re-treatment. Results: Of the women who participated in the randomized trial 74{\%} (482 of 655) were enrolled in the followup study. Urinary continence rates decreased during a period of 2 to 7 years postoperatively from 42{\%} to 13{\%} in the Burch group and from 52{\%} to 27{\%} in the sling group, respectively. Among the baseline factors included in the first multivariable model age (p = 0.03), prior stress urinary incontinence surgery (p = 0.02), menopausal status (0.005), urge index (0.006), assigned surgery (p = 0.01) and recruiting site (p = 0.02) were independently associated with increased risk of incontinence. In the final multivariable model including baseline and postoperative factors, Burch surgery (p = 0.01), baseline variables of prior urinary incontinence surgery (p = 0.04), menopausal status (p = 0.03) and postoperative urge index (p <0.001) were each significantly associated with a greater risk of recurrent urinary incontinence. Conclusions: Preoperative and postoperative urgency incontinence symptoms, Burch urethropexy, prior stress urinary incontinence surgery and menopausal status were negatively associated with long-term continence rates. More effective treatment of urgency urinary incontinence in patients who undergo stress urinary incontinence surgery may improve long-term overall continence status.",
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AU - Richter, Holly E.

AU - Brubaker, Linda

AU - Stoddard, Anne M.

AU - Xu, Yan

AU - Zyczynski, Halina M.

AU - Norton, Peggy

AU - Sirls, Larry T.

AU - Kraus, Stephen R

AU - Chai, Toby C.

AU - Zimmern, Philippe

AU - Gormley, E. Ann

AU - Kusek, John W.

AU - Albo, Michael E.

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N2 - Purpose: We examined preoperative and postoperative patient related factors associated with continence status up to 7 years after surgery for stress urinary incontinence. Materials and Methods: Women randomized to Burch colposuspension or fascial sling surgery and assessed for the primary outcome of urinary continence 2 years after surgery were eligible to enroll in a prospective observational study. Survival analysis was used to investigate baseline and postoperative factors in the subsequent risk of stress urinary incontinence, defined as self-report of stress urinary incontinence symptoms, incontinence episodes on a 3-day diary or surgical re-treatment. Results: Of the women who participated in the randomized trial 74% (482 of 655) were enrolled in the followup study. Urinary continence rates decreased during a period of 2 to 7 years postoperatively from 42% to 13% in the Burch group and from 52% to 27% in the sling group, respectively. Among the baseline factors included in the first multivariable model age (p = 0.03), prior stress urinary incontinence surgery (p = 0.02), menopausal status (0.005), urge index (0.006), assigned surgery (p = 0.01) and recruiting site (p = 0.02) were independently associated with increased risk of incontinence. In the final multivariable model including baseline and postoperative factors, Burch surgery (p = 0.01), baseline variables of prior urinary incontinence surgery (p = 0.04), menopausal status (p = 0.03) and postoperative urge index (p <0.001) were each significantly associated with a greater risk of recurrent urinary incontinence. Conclusions: Preoperative and postoperative urgency incontinence symptoms, Burch urethropexy, prior stress urinary incontinence surgery and menopausal status were negatively associated with long-term continence rates. More effective treatment of urgency urinary incontinence in patients who undergo stress urinary incontinence surgery may improve long-term overall continence status.

AB - Purpose: We examined preoperative and postoperative patient related factors associated with continence status up to 7 years after surgery for stress urinary incontinence. Materials and Methods: Women randomized to Burch colposuspension or fascial sling surgery and assessed for the primary outcome of urinary continence 2 years after surgery were eligible to enroll in a prospective observational study. Survival analysis was used to investigate baseline and postoperative factors in the subsequent risk of stress urinary incontinence, defined as self-report of stress urinary incontinence symptoms, incontinence episodes on a 3-day diary or surgical re-treatment. Results: Of the women who participated in the randomized trial 74% (482 of 655) were enrolled in the followup study. Urinary continence rates decreased during a period of 2 to 7 years postoperatively from 42% to 13% in the Burch group and from 52% to 27% in the sling group, respectively. Among the baseline factors included in the first multivariable model age (p = 0.03), prior stress urinary incontinence surgery (p = 0.02), menopausal status (0.005), urge index (0.006), assigned surgery (p = 0.01) and recruiting site (p = 0.02) were independently associated with increased risk of incontinence. In the final multivariable model including baseline and postoperative factors, Burch surgery (p = 0.01), baseline variables of prior urinary incontinence surgery (p = 0.04), menopausal status (p = 0.03) and postoperative urge index (p <0.001) were each significantly associated with a greater risk of recurrent urinary incontinence. Conclusions: Preoperative and postoperative urgency incontinence symptoms, Burch urethropexy, prior stress urinary incontinence surgery and menopausal status were negatively associated with long-term continence rates. More effective treatment of urgency urinary incontinence in patients who undergo stress urinary incontinence surgery may improve long-term overall continence status.

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KW - surgical procedures

KW - treatment outcome

KW - urge

KW - urinary incontinence

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