Quality of Life in Women after UrogynecologicalSurgery

Overview

Objective:
The aim of this study is to verify the change in the quality of life, by a subjective assessmentof women, following their surgery for stress incontinence. We also evaluate any connection withpostoperative complications. Design: A pilot prospective study.Setting: Department of Obstetrics and Gynecology General Faculty Hospital, 1st Medical Faculty,Charles University, Prague.Methods: Quality of life is measured in accordance with the results of a questionnaire. We chose touse a standardized questionnaire by Donald L. Patrick „Incontinence of Life Instrument“ (I-QoL).I-QoL consists of 22 subjects of measure, each with a five point scale, addressing various aspects ofurine incontinence.We assessed the percentage results of I-QoL before and between 3-6 months aftersurgery for a connection to postoperative complications.Results: Our patient set was 64 women, all of whom had undergone an operation for stressincontinence. The most common was Kolpopexis secundum Burch at 74%. The average age of thesubjects was 54. 59.4% of those tested displayed BMI in excess of 25, whilst 49% of the women hadpreviously undergone laparotomy surgery. The average value of I-QoL before the operation was46.21%. In the second reading, post operation, this had risen to 80.86%. The difference of 34.65%strongly suggests a significant rise in the quality of life following the operation. 68.74% (44x) of thewomen were significantly improved, meaning their quality of life had increased by at least 13%.12.5% (8x) showed slight improvement, 14.07% (9x) maintained their quality of life, and just 4.68%(3x) showed signs of deterioration.We found the biggest improvements in those suffering with stressincontinence. The patients felt generally more healthy, helping to reduce the depression and anxietyassociated with incontinence. In contrast, our treatment caused a case of postoperative urgency andnycturia.Conclusion: Early complications had no impact on the quality of life, but those which came later -urgency andnycturia did.Theresult of I-QoL generally depends on the intensity of difficulties beforethe operation. The question to ask is, whether the subjective assessment can ever be used asa comparison to the objective research.

Key words:
stress incontinence, questionnaire I-QoL, early and later postoperative complication,quality of life