PREDICTIVE FACTORS OF THE OUTCOME OF PRIMARY SURGICAL-TREATMENT OF STRESS-INCONTINENCE IN WOMEN

Forty-five women with stress incontinence (mean age 50 years) schedule d for surgical treatment randomized either to retropubic urethrocystop exy or to pubococcygeal repair were prospectively studied. Fifty healt hy women were used as a reference group. No difference emerged concern ing the outcome for these two Surgical techniques in terms of success rate. Consequently, the subjects were treated as one group. The aim of the study was to test for predictive factors of the outcome of surgic al treatment. Age of the patient, duration of stress incontinence, par ity, personality, psychological and social factors were investigated. The outcome of surgical treatment was estimated both subjectively and objectively (pad test). The women were classified as cured or improved /failure. There was an 80% concordance between subjective and objectiv e methods. In the stress incontinent women who were improved/failure o ne year after surgery, a high degree of neuroticism, low degree of ext raversion, high degree of somatic anxiety, psychic anxiety, psychasthe nia and suspicion was observed compared to the cured women. Furthermor e, the improved/failure women had a lower level of social integration, in terms of loneliness compared to the cured women. Our findings poin t to the need of psychosocial support and care in addition to the medi cal treatment. According to a stepwise logistic regression analysis th ree variables have been found of importance as predictors of the outco me of the surgical treatment: duration of stress incontinence, neuroti cism and age of patient.