The effect of age on stress and urgency urinary incontinence outcomes in women undergoing primary midurethral sling.

INTRODUCTION AND HYPOTHESIS

The primary aim was to characterize stress urinary incontinence (SUI) symptom distress and impact after a midurethral sling (MUS) in women ≥70 compared to women <70 years of age.

METHODS

A retrospective cohort study of women undergoing a primary MUS was conducted. The primary outcome was SUI symptoms defined as either "moderately" or "quite a bit" responses to ≥1 of the two SUI questions of the Pelvic Floor Distress Inventory-20 (PFDI-20). Urgency urinary incontinence (UUI) was defined as either moderately or quite a bit responses to the UUI question of the PFDI-20. The Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Satisfaction Questionnaire (PSQ), and Patient Global Impression of Improvement (PGI-I) questionnaires were also administered.

RESULTS

The mean age of patients ≥70 years (n = 160) was 75.4 ± 4.5 and <70 years (n = 536) was 56.2 ± 9.4. Multivariable analysis revealed no difference in SUI failure rates in older compared to younger cohorts, adjusted odds ratio (OR) 1.7, 95 % confidence interval (CI) 0.9-3.1. Women <70 demonstrated greater improvement in urinary incontinence (UI) symptom impact [-20.4 (33.0) vs -12.2 (30.7), p = 0.01] and women ≥70 had greater persistent UUI symptoms (31.5 vs 23.3 %, p = 0.04); there was no difference between cohorts in resolution of UUI (29.6 vs 34.2 %, p = 0.34). Younger women reported a greater impression of improvement compared to older women (67.7 vs 56.6 %, p = 0.01, respectively).

CONCLUSIONS

Older and younger women have similar SUI outcomes after MUS; however, older women have more persistent UUI and a worse impression of improvement of their urinary tract condition.