Home About us Contact
|
Home About us Contact | ||
|
|
||
Distress Inventory (distress + inventory)
Kinds of Distress Inventory Selected AbstractsUrodynamics, the supine empty bladder stress test, and incontinence severity,,§NEUROUROLOGY AND URODYNAMICS, Issue 7 2010Charles W. Nager Abstract Aims Determine whether urodynamic measures of urethral function [(valsalva leak point pressure (VLPP), maximum urethral closure pressure (MUCP), functional urethral length (FUL)] and the results of the supine empty bladder stress test (SEBST) correlate with each other and with subjective and objective measures of urinary incontinence (UI). Methods Data were collected preoperatively from subjects enrolled in a multicenter surgical trial of mid-urethral slings. Subjective measures included questionnaire scores from the Medical Epidemiological and Social Aspects of Aging Questionnaire, Urogenital Distress Inventory, and Incontinence Impact Questionnaire. Objective measures included a 24-hr pad weight test, incontinence episode frequency on a 3-day voiding diary, and a SEBST. Results Five hundred ninety-seven women enrolled. Three hundred seventy-two women had valid VLPP values; 539 had valid MUCP/FUL values. Subjective measures of severity had weak to moderate correlation with each other (r,=,0.25,0.43) and with objective measures of severity (r,=,,0.06 to 0.45). VLPP and MUCP had moderate correlation with each other (r,=,0.36, ,<,0.001). Urodynamic measures of urethral function had little or no correlation with subjective or objective measures of severity. Subjects with a positive SEBST had more subjective and objective severity measures compared to the negative SEBST group, but they did not have significantly different VLPP and MUCP values. Conclusions VLPP and MUCP have moderate correlation with each other, but each had little or no correlation with subjective or objective measures of severity or with the results of the SEBST. This data suggests that the urodynamic measures of urethral function are not related to subjective or objective measures of UI severity. Neurourol. Urodynam. 29:1306,1311, 2010. © 2010 Wiley-Liss, Inc. [source] Mixed incontinence: Comparing definitions in women having stress incontinence surgery,,§¶NEUROUROLOGY AND URODYNAMICS, Issue 4 2009Linda Brubaker Abstract Objective To develop an empirically derived definition of mixed urinary incontinence (MUI) for use in incontinence outcomes research. Methods Participants in a randomized trial comparing the fascial sling and. Burch colposuspension were assessed using standardized measures including the Medical, Epidemiologic and Social Aspects of Aging (MESA), UI questionnaire, the Urogenital Distress Inventory (UDI), 3-day urinary diary and urodynamic studies (UDS). Participants were required to have stress incontinence with a MESA stress subscale score,>,MESA urge subscale score. Several definitions of MUI were considered. Logistic and linear regression analysis methods were used to predict clinical outcomes based on the different MUI definitions. Analyses were carried out using SAS (SAS Institute, Inc., Cary, NC, Version 9.1). Statistical significance was defined at P -value <0.05. Results In 655 participants, the proportion of women with MUI varied from 8.3% to 93.3% depending on the MUI definition All definitions were associated with severity as measured by the frequency of incontinence episodes at baseline; however little of the variability was explained by any single definition. No strict cut-off value for these baseline measures was identified to predict clinical outcomes. Conclusions These MUI definitions do not adequately categorize clinically relevant UI subgroups. For research reporting, MUI subcomponents of stress and urge UI should be described separately rather than as a single dimension. Neurourol. Urodynam. 28:268,273, 2009. © 2009 Wiley-Liss, Inc. [source] Arabic validation of the short form of Urogenital Distress Inventory (UDI-6) questionnaire,,NEUROUROLOGY AND URODYNAMICS, Issue 4 2009Waleed Altaweel FRCS(C) Abstract Aims To translate and validate the Arabic version of the short form of Urogenital Distress Inventory (UDI-6) questionnaire in a sample of women with lower urinary tract symptoms (LUTS). Methods Two native Saudis independently translated the original UDI-6 into Arabic. These two translations were harmonized, and then checked by independent back translation by two English teachers. They collaborated with the clinical investigators to reach a consensus version of the questionnaire. The harmonized version was pre-tested in a pilot study on 20 patients. The final version of the UDI-6 was applied to 68 consecutive patients aged 22 years or over complaining of LUTS for at least 3 months at our tertiary care hospital. The patients were rerated after 1 week to assess test,retest reliability. To assess the capacity of the questionnaire to discriminate between women with and without LUTS, cases, and controls of healthy women sample were involved and assessed. The psychometric properties of the questionnaire, such as reliability and validity were assessed. Results The correlation co-efficient between ratings was >0.75 and the discriminate power between cases and control were confirmed. The UDI showed good internal consistency total score cronbach ,,=,0.71. Conclusions The Arabic version of UDI-6 is a valid and robust instrument and a reliable method to use in daily practice and clinical research. Neurourol. Urodynam. 28:330,334, 2009. © 2009 Wiley-Liss, Inc. [source] Impact of urodynamic based incontinence diagnosis on quality of life in women,,NEUROUROLOGY AND URODYNAMICS, Issue 3 2009Alexandra L. Haessler Abstract Aims To characterize the effect of urodynamic diagnosis on degree of incontinence related bother and health related quality of life in a large, multi-ethnic population of women. Methods Effects of multichannel urodynamic diagnosis, urethral competency, and other patient characteristics on abbreviated Urogenital Distress Inventory (UDI6) and Incontinence Impact Questionnaire (IIQ7) composite scores were analyzed retrospectively. Results Six hundred eleven patients were included. Mean UDI6 and IIQ7 scores were significantly higher among patients with mixed incontinence, detrusor overactivity, urinary stress incontinence with overactive bladder, and negative studies compared to those with stress incontinence without OAB. The relative composite UDI6 and IIQ7 mean scores did not significantly differ between the mixed incontinence, detrusor overactivity, stress incontinence with OAB and negative study groups. UDI6 and IIQ7 scores were significantly higher among stress incontinent patients with intrinsic sphincter deficiency, but similar among mixed incontinent patients with intrinsic sphincter deficiency. Conclusion Urodynamic diagnoses of detrusor overactivity, mixed incontinence, and stress incontinence with overactive bladder are associated with significantly worse incontinence related bother and health related quality of life when compared to those with stress incontinence without OAB. These conditions appear to have similar degree of impact on incontinence related bother and quality of life. Patients presenting with symptoms of incontinence can suffer a similar compromise in quality of life despite a negative MCUD study. Neurourol. Urodynam. 28:183,187, 2009. © 2008 Wiley-Liss, Inc. [source] Patient reported and anatomical outcomes after surgery for pelvic organ prolapse,,NEUROUROLOGY AND URODYNAMICS, Issue 3 2009Ahmed S. El-Azab Abstract Aim Primary aim was to modify Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) to assess pelvic organ prolapse (POP) in Arabic Muslim women. Secondary aim was to compare functional and anatomical outcomes of POP repair. Methods Questionnaire. A characteristic (prayer) was added to PFIQ. Linguistic validation of questionnaires was then done. Twenty cases were enrolled in a pilot study to test internal consistency and reliability. Subsequent study. Prospective study included women with symptomatic POP,,,stage II. History, examination by POP-Q, and administration of PFDI and PFIQ, were done before and 6 months after surgery. Results Questionnaire. Internal consistency of added question was good (Cronbach ,,=,0.78). Test,retest reliability of individual PFIQ items was variable. Subsequent Study. Between September 2004 and February 2007, 78 consecutive women were included. Cystocele, rectocele, and no site predominated in 74.4%, 17.9% and 7.7% of cases, respectively. Preoperatively 19.2%, 15.4% and 47.4% reported stress, urge, and mixed incontinence, respectively. Overall and individual urinary symptoms scores improved significantly after surgery. There were significant improvements in individual symptoms of constipation, splint to defecate and losing not well formed stools. Low self-esteem was most negative impact of prolapse on quality of life (QoL) followed by prayer. After surgery 90% of subjects had anatomical cure. After surgery, QoL issues are significantly related to anatomic location of prolapse as determined by POP-Q. Conclusions Modified PFIQ and PFDI are suitable to assess POP among Muslim women. Postoperatively, many prolapse-related symptoms and QoL significantly improve after surgery on the short term with an anatomic cure rate of 90%. Neurourol. Urodynam. 28:219,224, 2009. © 2008 Wiley-Liss, Inc. [source] Are there differences between women with urge predominant and stress predominant mixed urinary incontinence?,NEUROUROLOGY AND URODYNAMICS, Issue 2 2007Jack B. Lewis Abstract Objective We sought to determine if there are differences in clinical and urodynamic parameters between women with urge predominant and those with stress predominant mixed urinary incontinence (MUI). Methods Charts of 99 female patients with complaints of MUI were reviewed. Patients were divided into two groups based on the subjective predominance of either stress incontinence (MSUI) or urge incontinence (MUUI). All patients completed a subjective evaluation including an AUA Symptom Index, Urogenital Distress Inventory (UDI-6), and Incontinence Impact Questionnaire (IIQ-7). Objective non-invasive measures included physical exam, 48-hr voiding diary, and a 24-hr pad test. Videourodynamics studies (VUDS), performed in all patients, were reviewed and the presence and characteristics of detrusor overactivity (DO) and stress incontinence were noted. Results There were no significant differences between groups with respect to symptom scores. MUUI patients had significantly higher pad usage, and lower maximum and average voided volumes than MSUI patients. They were also more likely to have lower urodynamic bladder capacities and demonstrable DO (70% vs. 26%) on VUDS with contractions occurring at lower bladder volumes and with higher amplitude. MSUI patients were more likely to have demonstrable SUI on physical examination (63% vs. 16%) and on VUDS (100% vs. 61%). Conclusions There do appear to be differences in clinical and urodynamic parameters between patients with stress predominant and urge predominant MUI. These may help to determine which component of the mixed incontinence is more problematic. Neurourol. Urodynam. 26:204,207, 2007. © 2006 Wiley-Liss, Inc. [source] Preoperative erectile function is one predictor for post prostatectomy incontinence,NEUROUROLOGY AND URODYNAMICS, Issue 1 2007S. Wille Abstract Aims The precise etiology of post prostatectomy incontinence (PPI) is not fully understood and risk factors are not yet comprehensively defined. It has been reported that sparing of the neurovascular bundle during prostatectomy improves postoperative erectile function, whereas the influence on urinary control is unclear. From daily clinical experience we made the impression that patients who are in the best shape have better erections and better continence. We therefore searched our database for a possible correlation between the preoperative erectile function and the incidence of PPI. Patients and Methods Four hundred three patients who underwent radical retropubic prostatectomy between January 2000 and May 2003 were enrolled into this retrospective study. Data of 327 patients (response rate 81%) at a median follow-up of 26 months were analyzed using the validated International Index of Erectile Function (IIEF 5), the validated Urinary Distress Inventory (UDI6) and a standardized urinary symptom inventory. Continence was defined as usage of no or one pad daily. Erectile Dysfunction (ED) was defined as none/mild or moderate/severe with an IIEF 5 score of 17 or more or less than 17, respectively. Results Univariate and mulitvariate logistic regression analysis including preoperative IIEF 5 scores, age and nerve sparing prostatectomy, identified preoperative erectile function as significant predictor for PPI (P,=,0.024), whereas age (P,=,0.759) and nerve sparing prostatectomy (P,=,0.504) did not predict PPI. Conclusion Erectile function is a predictor of PPI and should be recorded preoperatively. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source] Measuring health-related quality of life in women with urogenital dysfunction: The urogenital distress inventory and incontinence impact questionnaire revisitedNEUROUROLOGY AND URODYNAMICS, Issue 2 2003C. Huub van der Vaart Abstract Aims Symptoms of urogenital dysfunction are known to negatively affect health-related quality of life in women. To assess effectiveness of treatment, it is currently recommended to include measurements of quality of life in outcome analysis. One of the questionnaires that is commonly used is the combination of the Urogenital Distress Inventory (UDI) and Incontinence Impact Questionnaire (IIQ). Unfortunately, the validity of the UDI and IIQ has only been tested in highly selected subgroups of female patients. Therefore, it is unclear whether this questionnaire is suitable for use in populations with different characteristics. Methods We analyzed the scale construction and validity of the UDI and IIQ in a random sample of 2,042 women, aged 20,70 years old and a clinical sample of 196 women. Results Our results show that the UDI can be divided into five subscales, namely discomfort/pain, urinary incontinence, overactive bladder, genital prolapse, and obstructive micturition. The internal consistency (Cronbach's alpha) ranged between 0.74 and 0.82. In addition to the original four subscales of the IIQ (mobility, physical, social, and emotional functioning), we identified a fifth subscale with four items about embarrassment. Internal consistency of these subscales ranged between 0.83 and 0.93. In addition to the internal consistency, we tested the criterion and construct validity of these new subscale division. Conclusions We found these subscales to be reliable and of clinical use. It is recommended to use the revised UDI and IIQ in outcome analysis of treatments for urogenital symptoms in women. Neurourol. Urodynam. 22:97,104, 2003. © 2003 Wiley-Liss, Inc. [source] Urinary incontinence symptom scores and urodynamic diagnosesNEUROUROLOGY AND URODYNAMICS, Issue 1 2002Mary P. FitzGerald Abstract The aim of this study was to determine whether scores on two validated urinary incontinence symptom scales predicted eventual urodynamic diagnoses. Two hundred ninety-three patients undergoing multi-channel urodynamic testing rated their symptoms of urinary incontinence and/or pelvic organ prolapse (POP), using the Incontinence Impact Questionnaire, the Urogenital Distress Inventory, and an obstructive symptom subscale from the long form of the Incontinence Impact Questionnaire. Among the 202 (69%) patients without advance-stage POP, increasing scores on scale items related to stress and urge incontinence predicted increasing frequency of the diagnoses of genuine stress incontinence (GSI) and detrusor instability, respectively. Among the 91 (31%) patients with advance-stage POP, there was no association. Among all patients with GSI, the presence of intrinsic sphincter deficiency could not be predicted by responses to the symptom scales. Scores on the symptom scales were inadequate predictors of eventual urodynamic diagnoses, especially among women with advance-stage POP. Neurourol. Urodynam. 21:30,35, 2002. © 2002 Wiley-Liss, Inc. [source] Short-term Impact of Tension-free Vaginal Tape Obturator Procedure on Sexual Function in Women with Stress Urinary IncontinenceTHE JOURNAL OF SEXUAL MEDICINE, Issue 4pt1 2010Hui-Hsuan Lau MD ABSTRACT Introduction., The tension-free vaginal tape obturator (TVT-O) procedure is one of the most commonly used anti-incontinence surgeries, but little is known about its impact on sexual function. Aim., To evaluate sexual function after the TVT-O procedure at 6 months postoperatively. Methods., Fifty-six sexually active women who underwent the TVT-O procedure for severe stress urinary incontinence (SUI) were evaluated using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) before and 6 months after surgery. The perception of incontinence-related quality-of-life were also evaluated by the short form of the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) to assess the effect of surgery on incontinence. Main Outcome Measures., Total score and score for each PISQ-12 item. Results., The mean total PISQ-12 score did not differ significantly before (24.0 ± 12.2) and after (23.0 ± 13.2) (P = 0.194) the TVT-O procedure. Scores for individual items on the PISQ-12 varied, with incontinence-related items improving but others, such as the frequency of achieving orgasm deteriorating for some women. The scores of UDI-6 and IIQ-7 were significantly improved by 6-month follow-up, indicating that the operation successfully resolved the incontinence. Conclusion., Despite successful amelioration of SUI by the TVT-O procedure, sexual function does not necessarily improve in the first 6 months after surgery. Lau H-H, Su T-H, Su C-H, Lee M-Y, and Sun FJ. Short-term Impact of tension-free vaginal tape obturator procedure on sexual function in women with stress urinary incontinence. J Sex Med 2010;7:1578,1584. [source] ORIGINAL RESEARCH,SURGERY: Short Term Impact on Female Sexual Function of Pelvic Floor Reconstruction with the Prolift ProcedureTHE JOURNAL OF SEXUAL MEDICINE, Issue 11 2009Tsung-Hsien Su MD ABSTRACT Introduction., The Prolift system is an effective and safe procedure using mesh reinforcement for vaginal reconstruction of pelvic organ prolapse (POP), but its effect on sexual function is unclear. Aim., To evaluate the impact of transvaginal pelvic reconstruction with Prolift on female sexual function at 6 months post-operatively. Methods., Thirty-three sexually active women who underwent Prolift mesh pelvic floor reconstruction for symptomatic POP were evaluated before and 6 months after surgery. Their sexual function was assessed by using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) before and after surgery. The quality of life was also evaluated with the short forms of the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) as a control for efficacy of the procedure. The Pelvic Organ Prolapse Quantification system was used to evaluate the degree of prolapse. Main Outcome Measures., PISQ-12 scores at 6 months post-operatively. Results., The total PISQ-12 score decreased from 29.5 ± 9.0 to 19.3 ± 14.7 (P < 0.001), indicating worsening of sexual function 6 months post-operatively. The behavioral, physical, and partner-related domains of PISQ-12 were each significantly reduced (5.2 ± 3.7 vs. 2.9 ± 3.7, P = 0.016; 15.4 ± 4.7 vs. 10.4 ± 8.6, P = 0.001; 8.9 ± 3.8 vs. 6.4 ± 5.5, P = 0.01, respectively). UDI-6 and IIQ-7 scores were significantly improved at the 6-month follow-up, as was anatomic recovery. Of the 33 subjects, 24 (73%) had worse sexual function 6 months after the procedure. Conclusion., The Prolift procedure provided an effective anatomic cure of POP, but it had an adverse effect on sexual function at 6 months after surgery. Su TH, Lau HH, Huang WC, Chen SS, Lin TY, Hsieh CH, and Yeh CY. Short term impact on female sexual function of pelvic floor reconstruction with the Prolift procedure. J Sex Med 2009;6:3201,3207. [source] Comparison of TVT and TVT-O in patients with stress urinary incontinence: Short-term cure rates and factors influencing the outcome.AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009A prospective randomised study Background: Recently, mid-urethral slings have been commonly used in treatment of patients with stress urinary incontinence (SUI). Aims: To investigate tension-free vaginal tape (TVT) and tension-free obturator tape (TVT-O) for surgical treatment of SUI for cure rates (primary endpoint), complications and factors influencing cure rate (secondary endpoints). Methods: One-hundred and sixty-four patients were included in the study (n = 81 for TVT, n = 83 for TVT-O). The cure rates, complications, preoperative and postoperative urodynamic evaluation, Q-tip test, the Turkish version of Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6) scores were recorded. At three and 12 months, the patients were evaluated regarding outcome measures. Results: The cure rates were similar in TVT and TVT-O groups, 88.9% versus 86.7% respectively. Mean operative time was significantly shorter in TVT-O group (P = 0.001). The cure rate was significantly higher in both groups in patients with urethral hypermobility when compared with those with no hypermobility (P = 0.001). Conclusions: The TVT and TVT-O procedures appear to be equally effective for the treatment of SUI. Also, urethral hypermobility seems to be a factor influencing cure rate of mid-urethral slings. [source] Long-term outcome of tension-free vaginal tape for treating stress incontinence in women with neuropathic bladdersBJU INTERNATIONAL, Issue 6 2010Ahmad Abdul-Rahman Study Type , Therapy (case series) Level of Evidence 4 OBJECTIVE To evaluate the long-term safety and efficacy of the tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in women with neuropathic bladder dysfunction. PATIENTS AND METHODS Twelve women (mean age 53.3 years, range 41,80) with neuropathic bladder dysfunction and SUI confirmed by video-cystometrography (VCMG) were treated with a TVT in one institution by an expert neuro-urologist between November 1997 and December 2000. The patient's notes, clinical annual follow-up and VCMG after the procedure, and the incontinence impact questionnaire (IIQ) forms (Urinary Distress Inventory, and IIQ-7) were assessed during the long-term clinical follow-up for SUI, in addition to a health-related quality of life assessment. The cure of SUI was defined as no loss of urine on physical exercise, confirmed VCMG after the procedure, and by clinical assessment. RESULTS The mean (range) follow-up was 10 (8.5,12) years. Nine patients were using clean intermittent self-catheterization before the insertion of TVT and continued to do so afterward. At 10 years of follow-up, one patient had died (with failed TVT initially), and two were lost to follow-up at 5 years after surgery, but up to 5 years they did not complain of UI and VCMG did not show SUI. The remaining seven of the nine patients were completely dry, and two improved and were satisfied with using one or two pads/day. Two patients showed neurogenic detrusor overactivity confirmed on VCMG, with no evidence of SUI. One patient needed a transient urethral catheter for urinary retention after surgery, one had a bladder injury that required leaving the catheter for 5 days, but no urethral erosions were reported during the follow-up. CONCLUSIONS In women with neuropathic bladder dysfunction secondary to a variety of spinal cord pathologies, and who have SUI necessitating a definitive intervention, insertion of TVT should be considered a desirable treatment, with very good long-term outcomes. [source] Long-term quality-of-life outcome after mesh sacrocolpopexy for vaginal vault prolapseBJU INTERNATIONAL, Issue 11 2009Arun Z. Thomas OBJECTIVE To evaluate the long-term outcome of mesh sacrocolpopexy (MSC, which aims to restore normal pelvic floor anatomy to alleviate prolapse related symptoms) and its effect on patient's quality of life, as women with vaginal vault prolapse commonly have various pelvic floor symptoms that can affect urinary, rectal and sexual function. PATIENTS AND METHODS From January 2000 to June 2006, consecutive patients with confirmed stage 2,4 vaginal vault prolapse subsequently had a MSC. Detailed telephone interviews using the Cleveland Clinic Short Form-20 Pelvic Floor Distress Inventory (PFDI) questionnaire, with Urinary Distress Inventory (UDI), Pelvic Organ Prolapse Distress Inventory (POPDI) and Colorectal-Anal Distress Inventory (CRADI) subscales was completed by all patients to assess symptoms before and after MSC, improvement in sexual function and overall satisfaction. RESULTS In all, 21 patients had abdominal MSC; the median (range) follow-up was 52.2 (21,99) months. Total PFDI scores were significantly better after MSC (mean 44.0/300) than before (mean 113.9/300; P < 0.001). Analysis of the subscale scores showed that all patients reported a significant improvement of symptoms in the POPDI category (P < 0.001). CRADI subscale scores showed no significant change after MSC (before, mean 7.43/100 vs after 8.47/100; P = 0.542). There was an improvement of urinary symptoms on the UDI subscale after MSC but it was not statistically significant (P = 0.08). Analysis of score differences over time after MSC showed an insignificant decreasing slope (P = 0.227), suggesting long-term stability of symptoms after surgery; 90% of patients reported a significant improvement in sexual function and excellent long-term overall satisfaction with MSC. CONCLUSION Our results suggest that MSC is a safe and effective surgical option for treating vaginal vault prolapse, providing symptom improvement and stability in the long term. [source] Transobturator tape (TOT): Two years follow-up,NEUROUROLOGY AND URODYNAMICS, Issue 1 2007Saad Juma Abstract Aims The aim of this study is to report the functional results, patient satisfaction, and morbidity of the Transobturator tape procedure (TOT) in the treatment of stress incontinence (SUI). Methods One hundred and thirty patients were prospectively evaluated with history, physical examination, quality of life questionnaire including Incontinence Impact Questionnaire (IIQ), urogenital distress inventory (UDI), and analog global satisfaction scale (GSS), and urodynamic studies. Results One hundred and seventeen patients (90%) had history of SUI, and 78 (60%) had urge incontinence. Pads/day (PPD) used was 2.48,±,2.42, and the score of IIQ 16.13,±,7.86, UDI 10.95,±,3.4, and GSS 1.41,±,1.67. All patients underwent TOT using the ObTapeÔ. Hospital stay was 0.84,±,0.76 days and catheter duration was 1.42,±,2.08 days. At a follow-up of 16.85,±, 4.68 months, 13 patients (10%) have recurrent SUI, 21 (16.15%) persistent urge incontinence, and 1 (1.92%) de novo urge incontinence. The mean PPD is 0.15,±,0.56, IIQ 1.47,±,5.14, UDI 3.28,±,3.09, and GSS 8.29,±,1.64. Two patients (1.52%) developed urethral obstruction, five (3.84%) had vaginal extrusion of the tape, and two (1.52%) had intra-operative bladder perforation. Conclusions These results demonstrate the safety and efficacy of the TOT. The short hospitalization and catheterization, low incidence of de novo urge incontinence and obstructive voiding offers a distinct advantage over existing techniques. No significant difference in outcome between patients with VLPP ,60 cm H2O, and patients with VLPP >60 cm H2O was observed. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source] Validation of the short forms of the incontinence impact questionnaire (IIQ-7) and the urogenital distress inventory (UDI-6) in a Turkish population,NEUROUROLOGY AND URODYNAMICS, Issue 1 2007Cetin Cam Abstract Aim To validate the Turkish versions of the IIQ-7 and UDI-6 for use in Turkish-speaking populations. Methods After establishing the test-retest reliability and internal consistency in a pilot study, 302 patients were enrolled in the study and general and subscale scores of the questionnaires were calculated. All participants underwent an urodynamic assessment. Results Both instruments showed a high internal consistency (Cronbach's alpha for the IIQ-7 and UDI-6 was 0.87 and 0.74, respectively) and test-retest reliability (Spearman's rho was 0.99 for both of the scales (P,<,0.001). 55.6% of the participants showed urodynamic abnormality and/or leakage. 39.7% had urodynamic stress incontinence (USI) and 15.9% had detrussor overactivity (DOA),±,USI. The mean scores of each IIQ-7 and UDI-6 were significantly higher in the USI, and DOA,±,USI groups compared with normal women. Women with DOA,±,USI scored highest in the IIQ-7 and UDI-6. The irritative subscale scores of the 1st and 2nd items of the UDI-6 were significantly higher in the DOA,±,USI group. The stress subscale scores of 3rd and 4th items of UDI-6 were significantly higher in the USI group. Women with postvoid residual (PVR) urine values greater than 50 ml had significantly higher obstructive subscale scores compared to the ones who had less residual volumes. Conclusions The Turkish translated versions of the IIQ-7 and UDI-6 are reliable, consistent and valid instruments for assessing symptom severity and the impact on QOL in Turkish speaking women with urinary incontinence. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source] A longitudinal study over 5 to 10 years of clinical outcomes in women with idiopathic detrusor overactivityBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2008AR Morris Objective, To evaluate the long-term clinical outcome in women with idiopathic detrusor overactivity (IDO) and to identify significant prognostic factors. Design, Longitudinal study incorporating retrospective case note review and a postal questionnaire. Setting, Tertiary referral urogynaecology clinic in Australia. Population, Women with a sole urodynamic diagnosis of IDO. Methods, Audit of urodynamic records and case notes. Postal questionnaire incorporating validated disease-specific quality-of-life (QoL) instruments. Main outcome measure, Subjective assessment of overall improvement on a 4-point scale followed by scoring of short forms of the urogenital distress inventory and incontinence impact questionnaire. Results, One hundred and thirty two women were identified following examination of 1975 consecutive records with 76 (67%) returning questionnaires. Median follow up was 8 years (6,9), and the duration of symptoms was 13 years (9,18). Improvement was achieved in 25 (35%) women. Disease symptoms fluctuated in severity and QoL were worse in nonresponders to therapy (P < 0.0001). Urge incontinence at presentation was associated with treatment failure (P= 0.001) as was nocturia (P= 0.04), but urodynamic variables were not associated with outcome. Only 3 of 46 (6.5%) women not responding to therapy thought that their symptoms would improve with time. Conclusions, IDO seldom resolves and fluctuates in severity. Individual response is unpredictable, although the presence of urge incontinence is associated with a significantly worse prognosis. [source] | ||||||||||