Study On QOL And Efficacy Of Surgical Intervention In Moderate And Severe SUI Patients In Hospital

Stress urinary incontinence(SUI)is one of the most common female diseases with high morbidity,especially in population of elderly females,which becomes a social problem of female health.Although SUI might not have threats on lives of patients,it has severe impact on quality of life(QOL).The trans-obturator tension-free vaginal tape inside-out procedure(TVT-O) is a new surgical procedure for treatment of SUI in recent years.Assessments of clinical efficacy always focus on aspects of symptom improvement,surgical invasion and complications.There was insufficient reported information on improvement of QOL.Using the combined methods of qualitative and quantitative analysis,this research concluded the QOL data and its influencing factors in SUI patients with moderate or severe symptoms preoperatively and postoperatively.We aimed to proposal political suggestions to improve QOL of SUI patients by deepening our understanding on the QOL status of SUI patients in hospital,their cognitive status of SUI and outcomes of surgical intervention.It is also complimentary for comprehensive evaluation on efficacy of TVT-O.Partâ… Quantitative Study on QOL and Efficacy of Surgical Intervention in Moderate and Severe SUI Patients in HospitalObjective:To evaluate the QOL status of SUI patients and analysis its influencing factors and to evaluate surgical efficacy by assessment of QOL in order to provide firm evidence in improving QOL of moderate and severe SUI patients.Methods:From Jun.2007 to Sep.2008,we evaluated 88 moderate or severe SUI patients who received TVT-O procedure in O&G dept.of Tongji hospital affiliated to Tongji university,by unified designed questionnaires of QOL for SUI patients.We described the general conditions of patients,preoperative and postoperative QOL scores,surgical conditions and analyzed influencing factors of QOL.Results:The mean duration of SUI symptom was 8.7 years,75%had no previous visit.The preoperative scoring results on QOL and three dimensions including behavior limitation,psychological impacts and social obstacles were extremely low, namely 62.8 points,22.3 points,29.3 points and 11.3 points.The scoring results of post-operation had significant improvement,raised to 98.4 points,35.3 points,42.3 points and 20.8 points.The severity of SUI,duration of SUI and maximum of delivered fetal weight resulted to be influencing factors on preoperative QOL.Among which,the severity of SUI,duration of SUI were influencing factors after operation. The mean operating time and EBL were 41.2 min and 33.4ml.There were no operative complications.Mean hospital stay was 7.0 days.95.5%patients were cured and 4.5%had improvement.There was no case with inefficacy or aggravation.Conclusions:Our data demonstrated that the moderate or severe SUI patients had taken along with symptoms with limited visiting rate.The symptoms of SUI seriously influenced patients' QOL.TVT-O procedure,with significant healing rate,few complications,short operating time,mini-invasion and quick recovery,can improve patients' QOL obviously.The SUI patients should receive early medical treatment in order to achieve better therapeutic effect.Partâ…¡Qualitative Study on Perceptions and Experiences on SUI and its Surgical InterventionObjective:To investigate patients' perceptions and experiences on SUI and the efficacy of surgical intervention in moderate and severe SUI patients,in order to provide firm evidence in evaluation of TVT-O procedure and measure of improving QOL.Methods:Qualitative individual interviews were given to 11 women with moderate or severe SUI symptoms who received TVT-O procedure in O&G dept.of Tongji hospital and performed individual interview two months after operation.Findings:The main themes from this study were:Patients with SUI did not seek treatment actively due to insufficient cognition of SUI;QOL of SUI patient was seriously influenced by the symptoms of SUI;and TVT-O was perceived promising with mini-invasion,but costly.Conclusions:It is necessary to carry out health education and promotion in population of SUI patients in order to improve their cognition of SUI and QOL. TVT-O is a good way to treating SUI.However,we should strengthen the development of medical materials to reduce operation costs.