Prevalence and Outcomes of Continence Surgery in Community Dwelling Women

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Abstract
Published outcomes of continence surgery are based largely on cohort studies and a smaller number of randomized trials. There is no consensus on the outcomes that should be considered and patient reported outcomes have not always been included. We determined the prevalence of continence surgery as well as patient reported outcomes in community dwelling women. We performed a 2-stage national cross-sectional mailed survey. A short questionnaire used to identify women with a history of continence surgery was sent to 45,000 representative American households. Eligible women with a history of continence surgery received a followup questionnaire to assess patient reported outcomes, including current symptom frequency, bother and overall satisfaction. Of the 24,581 women 967 (4%) had a history of continence surgery, including 73% who currently reported incontinence in the preceding month, 58% who reported incontinence in the preceding week and 53% who reported current use of pads or other absorbent material. Of those who reported incontinence 83% reported current stress incontinence symptoms, including 62% with stress and urge symptoms. A third of the women had been treated with surgery in the last 5 years. The proportion of women satisfied with the results of surgery decreased from 67% who recalled initial satisfaction to 45% who reported current satisfaction. Almost 4% of women had undergone continence surgery and continence rates were lower than most published figures. However, some women reported satisfaction with surgery even when they did not achieve continence. Patient satisfaction and other patient reported outcomes might be considered with continence rates when determining surgical success rates.