Programme no. 534-OP
Non face-to-face treatment of stress urinary incontinence - Predictors of long-term success
Anna Lindh*1, Eva Samuelsson2, Malin Sjöström3
1Department of Public Health and Clinical Medicine,Umeå University,Umeå,Sweden, 2Department of Public Health and Clinical Medicine,Umeå University,Umeå,Sweden, 3Department of Public Health and Clinical Medicine,Umeå University,Umeå,Sweden
* = Presenting author
Objectives: To determine possible predictors for long-term success in women treated with PFMT for SUI.
Background: The prevalence of female stress urinary incontinence (SUI), i.e the leakage of urine when sneezing, coughing, or on exertion, is 10-35%. First line of treatment for SUI is pelvic floor muscle training (PFMT) and life style changes. There are only few studies of the long-term results of PFMT, and little is known about possible predictors for a successful outcome.
Results: Of the participants, 77% (129/169) were successful in at least one of the outcome variables, and 23% (37/160) were successful in all three. The adjusted odds ratios (ORs) for success at one year were 5.15 (95% confidence interval (CI) 2.40-11.03) for PGI-I, 6.85 (95% CI 2.83-16.58) for ICIQ-UI SF, and 3.78 (95% CI 1.58-9.08) for sufficient treatment, for women that were successful in the corresponding outcome variable at 4-months, compared with those who were not. Older age (years) was a significant predictor for success in PGI-I and sufficient treatment, with the adjusted ORs of 1.06 (95% CI 1.02-1.10) and 1.08 (95% CI 1.03-1.13) respectively. Performing regular PFMT at one year was a significant predictor for success, compared with not training regularly, for the PGI and sufficient treatment (adjusted ORs; 2.32 (95% CI 1.04-5.20), and 2.99 (95% CI 1.23-7.27), respectively).
Material/Methods: Secondary analysis of data from a randomized controlled trial comparing two non face-to-face treatment programs for women with clinically relevant SUI (≥1/week), both based mainly on PFMT. We included all participants that answered the one-year follow-up (n=169, mean age 50.3 (SD 10.1) years), regardless of intervention group. Three outcome variables, Patient Global Impression of Improvement (PGI-I), International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short form (ICIQ-UI SF), and sufficient treatment were used to define success after one year. Data from baseline, the four-month, and one-year follow-ups were evaluated as potential predictors for success using logistic regression.
Conclusion: This study suggests that there are predictors that foresee long-term success in women with clinically relevant SUI treated with PFMT without face-to-face contact. A successful result at the four-month follow-up, performance of regular PFMT after one year, and older age were significant predictors for success. These results can be helpful when informing patients with SUI about PFMT in a clinical setting.
Points for discussion:
Clinically relevant outcome measures?
How can the results be used in a clinical setting?