Abstract
Objective. To perform a national survey on self-reported cure, satisfaction and complications four years after mid-urethral sling (MUS) for urinary stress incontinence in Danish women operated in 2001. Design. A postal questionnaire survey. Population. All Danish women who received an MUS operation in 2001 extracted from the Danish National Patient Register. Methods. The women received a validated postal questionnaire in 2005. The questionnaire included questions about subjective cure, satisfaction, complications and a Danish version of International Consultation on Incontinence Questionnaire-Short Form. The study was carried out in cooperation with the Danish National Board of Health. Results. A total of 335 (92%) women responded to the questionnaire, among whom 105 (32%) felt completely cured, 119 (36%) were much improved, 55 (17%) were improved and 48 (15%) unchanged or worse. Cure rate varied between departments from 0% to 67%. Low-volume departments (<10 operations/year) had a significantly (p = 0.05) lower cure rate compared to the department with a higher volume. Altogether, 238 (73%) women were very satisfied with their operation. Self-reported bladder emptying difficulties were reported by 103 (32%) and the need for clean intermittent catherization (CIC) at any stage was reported by 21 (7%). No woman was still performing CIC. Of the women, 126 (42%) had made contact with the healthcare system because of their operation after discharge from hospital. Conclusions. Long-term outcome of MUS operations in Denmark in terms of cure, satisfaction and complication rates seems comparable to international results; however, the decentralized organization with many low-volume departments seems inappropriate.
Declaration of interest: This study was funded by the Department of Gynecology and Obstetrics, Glostrup Hospital, Denmark, the Danish Centre for Health Technology Assessment, Johnson & Johnson/Gynecare (3 grants), an Organon research grant, the Danish Doctors Insurance Association of 1891, the Danish Doctors Research Fund, a Paula and Axel Nissen grant.
Gunnar Lose has acted for Contura (consultant, trial participation), Pfizer (trial participation), Coloplast (consultant), Ethicon (workshop honorarium) and Novartis (advisory board).
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