Gil Karen M, Somerville Amber M, Cichowski Sara, Savitski Jennifer L
Department of Obstetrics and Gynecology, Akron General Medical Center, Akron, OH, USA.
Health Qual Life Outcomes. 2009 Feb 5;7:8. doi: 10.1186/1477-7525-7-8.
Current research focuses on three variables in evaluating the impact of stress urinary incontinence (SUI) on daily living: severity of incontinence, distress or bother resulting from incontinence, and effect on health related quality of life (HRQoL). Understanding the impact of these variables is important as they are the driving force behind women seeking surgical treatment. Given the importance of HRQoL in determining need for treatment, as well as evaluating treatment success, this review provides an assessment of the degree to which HRQoL is impaired in women seeking surgical treatment.
PubMed searches for the terms "quality of life and distress and urinary incontinence" and "quality of life and bother and urinary incontinence" were performed with limits of English, human and female subjects through May 2008. All studies using validated instruments were included. No time limit was placed on the search.
Of 178 articles retrieved, 21 met the inclusion criteria, and 17 reported methods of scoring. The studies used the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). Wide ranges of mean and individual levels of severity of symptoms, UDI and IIQ scores were seen among women seeking surgical treatment. Fourteen studies reported baseline and post-surgical treatment distress and QoL data. Statistically significant improvements between baseline and post-surgical UDI and IIQ scores were reported in 12 studies. Reported cure rates ranged from 46% to 97%. Satisfaction with the procedure was reported in 4 studies and ranged from 84% to 91%. A minority of studies reported the relationship between reduction in symptoms and change in HRQoL.
HRQoL is the main reason women seek surgical treatment for incontinence and surgical treatment leads to a significant improvement in mean HRQoL scores. Assessment of HRQoL has proved less useful in identifying why individual women seek treatment for incontinence. Preliminary work has begun to characterize the interaction between severity of symptoms, distress or bother resulting from these urinary symptoms, impact on HRQoL, and treatment seeking behavior, but further research is needed. Greater standardization in the reporting of results of distress or bother and HRQoL would allow for comparison across studies.
目前的研究聚焦于评估压力性尿失禁（SUI）对日常生活影响的三个变量：失禁的严重程度、失禁导致的困扰或烦恼，以及对健康相关生活质量（HRQoL）的影响。了解这些变量的影响很重要，因为它们是女性寻求手术治疗的驱动力。鉴于HRQoL在确定治疗需求以及评估治疗成功方面的重要性，本综述对寻求手术治疗的女性中HRQoL受损的程度进行了评估。
在PubMed上搜索“生活质量与困扰与尿失禁”以及“生活质量与烦恼与尿失禁”等术语，搜索范围限定为英文、人类和女性受试者，截至2008年5月。纳入所有使用经过验证工具的研究。搜索没有时间限制。
在检索到的178篇文章中，21篇符合纳入标准，17篇报告了评分方法。这些研究使用了泌尿生殖系统困扰量表（UDI）和失禁影响问卷（IIQ）。在寻求手术治疗的女性中，症状严重程度、UDI和IIQ评分的平均水平和个体水平差异很大。14项研究报告了基线和手术后的困扰及生活质量数据。12项研究报告了基线和手术后UDI及IIQ评分在统计学上有显著改善。报告的治愈率在46%至97%之间。4项研究报告了对手术的满意度，范围在84%至91%之间。少数研究报告了症状减轻与HRQoL变化之间的关系。
HRQoL是女性寻求尿失禁手术治疗的主要原因，手术治疗可使平均HRQoL评分显著改善。事实证明，评估HRQoL在确定个别女性寻求尿失禁治疗的原因方面作用较小。初步工作已开始描述症状严重程度、这些泌尿症状导致的困扰或烦恼、对HRQoL的影响以及寻求治疗行为之间的相互作用，但仍需进一步研究。在困扰或烦恼以及HRQoL结果报告方面实现更大程度的标准化将有助于不同研究之间的比较。
