Predictors of success and satisfaction of nonsurgical therapy for stress urinary incontinence.
Predictors of success and satisfaction of nonsurgical therapy for stress urinary incontinence.
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DOI：
10.1097/aog.0b013e31825a6de7
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发表时间：
2012-07
影响因子：
7.2
通讯作者：
Richter HE
中科院分区：
文献类型：
--
作者：
Schaffer J;Nager CW;Xiang F;Borello-France D;Bradley CS;Wu JM;Mueller E;Norton P;Paraiso MF;Zyczynski H;Richter HE
确定可能预测女性压力性尿失禁(SUI)非手术治疗成功和满意度的因素。对参与多中心随机试验的SUI患者的基线人口学和临床特征进行评估，以寻找成功和满意度的潜在预测因素。在3个月后评估成功和满意结果，包括患者总体改善印象(PGI-I)、盆底压力性尿失禁问卷(PFDI)和患者满意度问卷(PSQ)。Logistic回归用于确定预测因素、调整治疗和其他重要的临床协变量。给出了调整后的优势比(AOR)、95%可信区间(CI)和相关的P值。446名女性被随机分为两组。根据PFDI的压力子量表，受过大学教育或更高学历且没有接受过UI手术的患者预测成功(AOR=1.61，95%CI为1.01~2.55；P=0.04；AOR=3.15，95%CI为1.04~9.53；P=0.04)。使用PGI-I预测绝经状态预测成功(AOR=2.52绝经后与绝经前，95%CI 1.29至4.95；AOR=1.32不确定绝经状态与绝经前，95%CI 0.65至2.66；p=0.03)。每周大小便失禁少于14次预示患者对PSQ的满意度(AOR=1.97，1.21~3.19；p=0.01)。这些预测因素在三个治疗组中没有不同。绝经、高学历、未做过尿失禁手术和较低的尿失禁频率被发现是非手术治疗SUI的成功和满意度的预测因素。这些信息可能有助于更好地使提供者和患者的期望与非手术治疗结果保持一致。ClinicalTrials.gov，www.Clinicaltrials.gov，NCT00270998。
To identify factors that may predict success and satisfaction in women undergoing nonsurgical therapy for stress urinary incontinence (SUI). Baseline demographic and clinical characteristics of women participating in a multicenter randomized trial of pessary, behavioral, or combined therapy for SUI were evaluated for potential predictors of success and satisfaction. Success and satisfaction outcomes were assessed at 3 months and included the Patient Global Impression of Improvement (PGI-I), stress incontinence subscale of the Pelvic Floor Distress Inventory (PFDI), and Patient Satisfaction Questionnaire (PSQ). Logistic regression was performed to identify predictors, adjusting for treatment and other important clinical covariates. Adjusted odds ratios (AOR), 95% confidence intervals (CI), and associated P-values are presented. Four hundred forty-six women were randomized. College education or higher and no previous UI surgery predicted success based on the stress subscale of the PFDI (AOR=1.61, 95% CI 1.01 to 2.55; p=0.04; AOR=3.15, 95% CI 1.04 to 9.53; p=0.04, respectively). Menopausal status predicted success using the PGI-I (AOR=2.52 postmenopausal vs premenopausal, 95% CI 1.29 to 4.95; AOR=1.32 unsure menopausal status vs pre-menopausal, 95% CI 0.65 to 2.66; p=0.03 across all three groups). Less than 14 incontinence episodes per week predicted satisfaction with the PSQ (AOR=1.97, 1.21 to 3.19; p=0.01). These predictors did not differ across the three treatment groups. Menopause, higher education, no previous UI surgery and lower incontinence frequency were found to be predictors of success and satisfaction with nonsurgical therapy for SUI. This information may help better align provider and patient expectations with nonsurgical treatment outcomes. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00270998.