Outcome measures for stress urinary incontinence treatment: can we minimally agree?

PURPOSE

The aim of the study was to present the different outcome measures used to evaluate stress urinary incontinence (SUI) surgical treatments and to discuss their interests.

METHOD

A review of the literature based on the PubMed and Cochrane Library databases was performed using the following keywords alone and/or in combination: SUI, outcomes, surgery, questionnaires, meta-analysis, and quality of life. The research was restricted to the English and French language between 1995 and 2014.

RESULTS

To assess the outcomes of a SUI surgery, it is relevant to report objective measurements, subjective outcomes, and surgical complications. Discrepancies exist in the use of tools. Voiding diaries have not been regularly adopted in practice contrary to pad test. Urodynamic measures did not predict the outcomes after surgery for SUI. Less than 40 % of surgeons used the most scientifically validated urinary incontinence symptom and QOL questionnaires as outcome measures (IIQ, IIQ-7, KHQ, I-QOL, UDI, or UDI-6). Due to time constraints, unfamiliarity with many of the tools, and a lack of widely accepted efficacy criteria, validated quality of life and symptom-related questionnaires are underused by clinicians in routine practice.

CONCLUSION

There is no consensus on the best way to define treatment success in the context of SUI. However, it is acknowledged that including patient-reported outcomes is essential. There is a need to uniform outcomes reporting tools to be able to compare data across studies and perform meaningful meta-analyses.