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Patient satisfaction with incontinence surgery remains high at a follow-up of up to 7 years despite declining continence rates over time, according to the authors of a large, multicenter study.
"Currently, surgeons use rather short-term outcome data when they are counseling women on incontinence surgery," said co-investigator Halina Zyczynski, MD, associate professor of obstetrics, gynecology, and reproductive services and medical director of the Center for Continence and Pelvic Floor Disorders at the University of Pittsburgh.
Dr. Zyczynski said this lack of long-term data led to E-SISTEr (Extended-Stress Incontinence Surgical Treatment Efficacy Trial), a study conducted by Dr. Zyczysnki and colleagues from the Urinary Incontinence Treatment Network.
For E-SISTEr, women who successfully completed 24-month follow-up were recruited to be evaluated for a period of 5 years. Of the original 655 patients, 485 patients (244 who received the sling and 241 who received a Burch) were recruited for E-SISTEr. Continence was measured by a 3-day voiding diary once per year, the Medical, Epidemiologic, and Social Aspects of Aging (MESA) questionnaire, and a query on retreatment once every 6 months. Inpatient visits were not required, and information was collected via phone or mail.
Continence was defined as no self-reported leakage by the voiding diaries, no self-reported stress-type urinary incontinence symptoms on MESA, and no seeking of retreatment for incontinence.
At 2-year follow-up, 52% of patients who underwent the sling procedure were considered continent compared to 43% of patients who underwent the Burch procedure. At 5-year follow-up, the continence rates for sling and Burch patients were 34% and 24%, respectively, Dr. Zyczynski reported at the AUA annual meeting in San Francisco.