Original Clinical Article

Prognostic indicators of poor short-term outcome of physiotherapy intervention in women with stress urinary incontinence†‡§

  1. Erik J.M. Hendriks1,2,3,¶,*,
  2. Alfons G.H. Kessels1,2,‖,
  3. Henrica C.W. de Vet4,††,
  4. Arnold T.M. Bernards5,‡‡,
  5. Rob A. de Bie1,2,3,§§

Article first published online: 27 MAY 2009

DOI: 10.1002/nau.20752

Issue

Neurourology and Urodynamics

Neurourology and Urodynamics

Volume 29, Issue 3, pages 336–343, March 2010

Additional Information

How to Cite

Hendriks, E. J., Kessels, A. G., de Vet, H. C., Bernards, A. T. and de Bie, R. A. (2010), Prognostic indicators of poor short-term outcome of physiotherapy intervention in women with stress urinary incontinence. Neurourology and Urodynamics, 29: 336–343. doi: 10.1002/nau.20752

Author Information

  1. 1

    Department of Epidemiology, Maastricht University, Maastricht, The Netherlands

  2. 2

    School for Public Health and Primary Care, CAPHRI at Maastricht University, Maastricht, The Netherlands

  3. 3

    Centre for Evidence Based Physiotherapy, Maastricht University, Maastricht, The Netherlands

  4. 4

    EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands

  5. 5

    Department of Research and Development, Dutch Institute for Allied Health Care, Amersfoort, The Netherlands

  1. Health Scientist, Epidemiologist, Senior Researcher, and Lecturer.

  2. ‖

    Statistician.

  3. ††

    Clinical Epidemiologist and Professor in Clinimetrics.

  4. ‡‡

    Physician and Lecturer.

  5. §§

    Movement Scientist, Epidemiologist, and Professor of Physiotherapy Research.

*Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.

  1. †

    Conflicts of interest: none.

  2. ‡

    Linda Brubaker led the review process.

  3. §

    Authors' Contributions: EJM Hendriks had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: EJM Hendriks, AGH Kessels, and HCW de Vet. Acquisition of data: EJM Hendriks, ATM Bernards. Analysis and interpretation of data: EJM Hendriks, A Kessels, and HCW de Vet. Drafting of the manuscript: EJM Hendriks, AGH Kessels, ATM Bernards, RA de Bie, and HCW de Vet. Critical revision of the manuscript for important intellectual content: EJM Hendriks, AGH Kessels, ATM Bernards, HCW de Vet, and RA de Bie. Statistical analysis: EJM Hendriks, AGH Kessels, and HCW de Vet. Obtained funding: EJM Hendriks.

Publication History

  1. Issue published online: 22 MAR 2010
  2. Article first published online: 27 MAY 2009
  3. Manuscript Accepted: 20 APR 2009
  4. Manuscript Received: 20 DEC 2008

Funded by

  • Dutch Ministry of Health, Welfare and Sports. Grant Number: 260785

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Keywords:

  • global perceived effectiveness;
  • leakage severity scale;
  • multivariable logistic regression;
  • physiotherapy;
  • prognostic indicators;
  • prospective cohort study;
  • stress urinary incontinence

Abstract

Aims

To identify prognostic indicators independently associated with poor outcome of physiotherapy intervention in women with primary or recurrent stress urinary incontinence (stress UI).

Methods

A prospective cohort study was performed in physiotherapy practices in primary care to identify prognostic indicators 12 weeks after initiation of physiotherapy intervention. Patients were referred by general practitioners or urogynecologists. Risk factors for stress UI were examined as potential prognostic indicators of poor outcome. The primary outcomes were defined as poor outcome on the binary Leakage Severity scale (LS scale) and the binary global perceived effectiveness (GPE) score.

Results

Two hundred sixty-seven women, with a mean age of 47.7 (SD = 8.3), with stress UI for at least 6 months were included. At 12 weeks, 43% and 59% of the women were considered recovered on the binary LS scale and the binary GPE score, respectively. Prognostic indicators associated with poor outcome included 11 indicators based on the binary LS scale and 8 based on the binary GPE score. The prognostic indicators shared by both models show that poor recovery was associated with women with severe stress UI, POP-Q stage > II, poor outcome of physiotherapy intervention for a previous UI episode, prolonged second stage of labor, BMI > 30, high psychological distress, and poor physical health.

Conclusions

This study provides robust evidence of clinically meaningful prognostic indicators of poor short-term outcome. These findings need to be confirmed by replication studies. Neurourol. Urodynam. 29:336–343, 2010. © 2009 Wiley-Liss, Inc.

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