Do women have realistic expectations of treatment for stress urinary incontinence?

Our objective was to determine what women find acceptable regarding treatment and outcomes for treatment of stress urinary incontinence (SUI), and correlate this to age, distress and quality of life (QOL).

This prospective cross-sectional IRB-approved study evaluated women with primary SUI. One hundred sequential women (mean age, 53.8 years) answered questionnaires on initial interview, including the Urogential Distress Inventory (UDI-6), the American Urologic Association QOL questionnaire, as well as other validated questions regarding treatment options and possible outcomes. Statistical analysis was performed using Chi Squared, Fisher Exact, and t tests as well as the Wilcoxon Rank Score.

Of the 100 women who submitted questionnaires, 22% overall expected a complete cure, 57% a good improvement, 12% to be able to cope better, and 9% expected any improvement at all. We found this to be a realistic expectation of possible outcomes of treatment, with 79% expecting a good improvement or cure for their SUI. The women were also asked what type of treatment they found acceptable for their SUI: 22% found a major surgery acceptable, 39% found a minor surgery acceptable, 32% found a clinical procedure acceptable, and 7% found medication acceptable. The majority of women (71%) found a minor surgery, like a transobturator tape, or a clinical procedure, like collagen injection, most desirable. These results were then analyzed for correlation to age, degree of distress (measured by UDI-6), and QOL (measured by AUA QOL score).

Overall women have realistic expectations of treatment for SUI. They are willing to accept varied results depending on their distress regarding incontinence. Choices regarding treatments are influenced by age, severity and quality of life. It may be beneficial to include the UDI-6, age and QOL score as a part of the work up and planning for treatment of SUI to better meet patient's expectations.