[Quality of life in women after urogynecologic surgery]

The aim of this study is to verify the change in the quality of life, by a subjective assessment of women, following their surgery for stress incontinence. We also evaluate any connection with postoperative complications.

A pilot prospective study.

Department of Obstetrics and Gynecology General Faculty Hospital, 1st Medical Faculty, Charles University, Prague.

Quality of life is measured in accordance with the results of a questionnaire. We chose to use a standardized questionnaire by Donald L. Patrick "Incontinence of Life Instrument" (I-QoL). I-QoL consists of 22 subjects of measure, each with a five point scale, addressing various aspects of urine incontinence. We assessed the percentage results of I-QoL before and between 3-6 months after surgery for a connection to postoperative complications.

Our patient set was 64 women, all of whom had undergone an operation for stress incontinence. The most common was Kolpopexis secundum Burch at 74%. The average age of the subjects was 54. 59.4% of those tested displayed BMI in excess of 25, whilst 49% of the women had previously undergone laparotomy surgery. The average value of I-QoL before the operation was 46.21%. In the second reading, post operation, this had risen to 80.86%. The difference of 34.65% strongly suggests a significant rise in the quality of life following the operation. 68.74% (44x) of the women were significantly improved, meaning their quality of life had increased by at least 13%. 12.5% (8x) showed slight improvement, 14.07% (9x) maintained their quality of life, and just 4.68% (3x) showed signs of deterioration. We found the biggest improvements in those suffering with stress incontinence. The patients felt generally more healthy, helping to reduce the depression and anxiety associated with incontinence. In contrast, our treatment caused a case of postoperative urgency and nycturia.

Early complications had no impact on the quality of life, but those which came later--urgency and nycturia did. The result of I-QoL generally depends on the intensity of difficulties before the operation. The question to ask is, whether the subjective assessment can ever be used as a comparison to the objective research.