Validated outcomes measures to assess the results of SUI and POP procedures

Abstract

The pelvic floor literature on surgical trials and research utilizes heterogeneous outcomes measures that render interpretation and comparison of results between groups challenging. This chapter comprises a selected review of objective and subjective outcomes measures that are used to assess stress urinary incontinence (SUI) and pelvic organ prolapse (POP) procedures. The methodology of patient-reported outcome (PRO) instrument validation is briefly reviewed. The International Continence Society (ICS) and the International Urogynecologic Association (IUGA) have published extensive standardization guides regarding the appropriate terminology and reporting processes for outcomes measures in pelvic floor research. Still, no universally accepted definitions of cure or success currently exist. Consequently, the advisory bodies have suggested using composite outcomes measures, which should include multiple subjective and objective instruments to comprehensively document the full impact of pelvic floor disorders and therapeutic interventions. However, there is no consensus on which instruments are optimal, how these measures should be used in clinical practice, or how the extensive surveying suggested for clinical trials can be reduced and refined effectively. As PROs in the pelvic floor literature continue to evolve, it is beneficial for the pelvic floor surgeon to be knowledgeable about the instruments available to assess these outcomes.