QUALITY OF LIFE IN WOMEN WITH STRESS URINARY. INCONTINENCE SEEKING SURGERY. Larry Sirls*, Royal Oak, MI; Sharon Tennstedt, Watertown, MA;.
e688
THE JOURNAL OF UROLOGY姞
Vol. 183, No. 4, Supplement, Tuesday, June 1, 2010
1776 QUALITY OF LIFE IN WOMEN WITH STRESS URINARY INCONTINENCE SEEKING SURGERY Larry Sirls*, Royal Oak, MI; Sharon Tennstedt, Watertown, MA; Michael Albo, San Diego, CA; Toby Chai, Baltimore, MD; Kimberly Kenton, Chicago, IL; E. Ann Gormley, Lebanon, NH; Amy Arisco, San Antonio, TX INTRODUCTION AND OBJECTIVES: To determine the association of clinicodemographic factors with incontinence-related quality of life (QoL) in women having surgery for stress urinary incontinence (SUI), and compare results for two measures of incontinence-specific QoL. METHODS: Baseline data from the Trial of Mid Urethral Slings (TOMUS) on 597 women were evaluated. QoL measures were the Incontinence Impact Questionnaire (IIQ) and International Consultation on Incontinence Questionnaire (ICIQ). Potential correlates included health status and history (body mass index [BMI], past UI treatment, smoking status, anal incontinence, history of urinary tract infections), type and severity of UI (MESA stress and urge UI indices, PGI-S), bother of UI (UDI), and sexual function. Multiple regression models were performed for each QoL instrument (IIQ/ICIQ). The models were repeated to include the measure of sexual function (PISQ) for sexually active women only. RESULTS: Factors associated with lower QoL on both IIQ and ICIQ were younger age, higher BMI, higher SUI index, more severe and bothersome UI symptoms (Table 1). Each instrument identified additional factors associated with lower QoL not identified by the other instrument. IIQ identified Hispanic ethnicity, poor health status and a higher urge UI index with lower QoL, while ICIQ identified prior UI treatment and more UI episodes per day with lower QoL. Sexually active women had a similar pattern of QoL correlates with the addition of increased incontinence episodes (IIQ and ICIQ) and more sexual dysfunction (IIQ only). CONCLUSIONS: In women planning SUI surgery, QoL is associated with non-UI factors as well as with the type, severity and degree of bother from UI symptoms. While many factors are associated with both IIQ and ICIQ there are differences in the clinicodemographic variables that impact the QoL assessment of each tool. More non-UI factors were associated with QoL when measured by IIQ (assesses the impact of UI on various activities, roles, and emotional states) than by ICIQ (assesses impact of UI on everyday life). More than one scale may be needed to evaluate QoL after SUI treatment outcome since the patient’s assessment of QoL has become an important part of the definition of treatment success.
Correlates
Est.*
IIQ p-value
R2 0.49
Est.*
ICIQ p-value
R2 0.49
Sociodemographic Age
-0.76
0.02
.
-0.03
0.06
.
0.003
.
.
0.74
Hispanic
189.17
.
.
12.86
.
.
Non-Hispanic White
158.98
.
.
12.83
.
.
Non-Hispanic Black
140.13
.
.
13.21
.
.
Non-Hispanic Other
183.92
.
.
13.41
.
0.06
.
0.01
0.13
.
0.24
.
Race and ethnicity group
SES
-0.27
. .
.
Health Status and History .
⬍.0001
.
.
Excellent
140.79
.
.
12.76
.
.
Very good
156.47
.
.
12.77
.
.
Good
174.82
.
.
13.42
.
.
Fair⫹Poor
200.14
.
.
13.35
.
.
General Health
BMI
1.27
0.01
.
0.04
0.05
.
Prior UI Treatment
.
0.09
.
.
0.004
. .
No
162.68
.
.
12.69
.
Yes
173.42
.
.
13.47
.
.
.
Frequent UTIs
.
0.44
0.60
No
163.33
.
.
13.21
.
Yes
172.77
.
.
12.94
.
.
.
Anal incontinence
.
0.97
0.09
No
167.94
.
.
13.31
.
Yes
168.17
.
.
12.84
.
.
.
Smoking status
.
0.82
0.82
. . . . . . . .
Never
165.31
.
.
12.99
.
.
Former
168.56
.
.
13.17
.
.
Current
170.29
.
.
13.08
.
.
UI Type and Severity Stress UI Index
0.77
0.0007
.
0.05 ⬍.0001
Urge UI Index
0.37
0.04
.
0.01
.
0.002
.
Normal
157.95
.
Mild
158.86
.
Moderate
163.69
Severe
191.7
UI Severity (PGI-S)
.
.
⬍.0001
.
.
12.58
.
.
.
11.22
.
.
.
.
12.79
.
.
.
.
15.72
.
.
.
0.2
⬍.0001
.
Incontinence episodes/day
1.78
Symptom bother (UDI)
0.65 ⬍.0001
Sexual Activity
.
.
0.28
0.12 0.05
0.01 .
.
0.0007
.
0.65
.
Not sexually active
175.2
.
.
13.15
.
.
Sexually active
160.9
.
.
13.01
.
.
Source of Funding: Supported by cooperative agreements from the National Institute of Diabetes and Digestive and Kidney Diseases U01 DK58231, U01 DK60379, U01 DK60380, U01 DK60401, U01 DK60397, U01 DK58225, U01 DK60395, U01 DK58234, U01 DK60393, U01 DK58229
1777 ANIMAL STUDY HISTOPATHOLOGY OF THE LONG TERM DURABILITY OF POLYDIMETHYLSILOXANE INJECTABLE BULKING AGENT IN URETHRAL TISSUES William Wustenberg*, Farmington, MN INTRODUCTION AND OBJECTIVES: Urethral bulking agents function by forming a space-occupying bolus in the urethral wall thereby increasing urethral closure pressures. Most bulking agents demonstrate short term clinical benefits. However, urethral bulking agents that dissipate lose efficacy over time. Long-term efficacy is related to the persistence of the space-occupying bolus. Polydimethylsiloxane (PDMS) implants (Macroplastique®) have an 18 year history of treatment for stress urinary incontinence. The long term histopathol-
