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Master Thesis

Chirurgie de l’incontinence urinaire à l’effort par bandelette sous-urétrale : score prédictif de l’amélioration

Abstract : Introduction: one in three woman will suffer from stress urinary incontinence (SUI) during their lifetime. Midurethral sling procedures have grown quickly. Ten percent of women are not improved after MUS and some have severe side effects. Objective: to identify preoperative factors affecting postoperative improvement and develop a predictive score. Methods: we performed an ancillary analysis of a randomized controlled trial. Stress urinary incontinent women were allocated to either TVT (tension-free vaginal tape) or TVT-O (transobturator tape). Post-operative improvement was assessed at 24 months by the PGI-I (Patient Global Impression of Improvement) score. We developed a predictive score based on logistic regression analysis. The score was internally validated by bootstrap method. Results: ninety two percent of patients (n=132/143) were improved (PGI-I=1 or 2) at 24 months. A predictive model with four variables was internally validated: BMI < 30kg/m2 (OR 5.65 [ 1.2-29.8] ; p=0.029); moderate urgency symptoms (OR 7.04 [ 1.5-37.3] ; p=0.014); urinary incontinence during running (OR 9.21 [ 1.8 - 50.7] ; p=0.008); common fear of giving off an unpleasant odour (OR 9.2 [2-55] ; p=0.007). The area under the curve of the model was 0.80. A predictive score (out of 30 points) was established. A score < 16 predicted a low chance of improvement of 61.5% [35.5-82.3]; a score > 21 predicted an improvement of 98.9%[94-99.8]. Conclusion: this improvement predictive score may help to inform patients and can guide operative decision of SUI.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03143939
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Submitted on : Wednesday, February 17, 2021 - 10:41:17 AM
Last modification on : Thursday, September 2, 2021 - 3:09:14 AM

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Pauline Dewaele. Chirurgie de l’incontinence urinaire à l’effort par bandelette sous-urétrale : score prédictif de l’amélioration. Médecine humaine et pathologie. 2019. ⟨dumas-03143939⟩

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