Patient global impression of change (PGIC) and ICIQ − urinary incontinence scoring systems demonstrate poor reliability of pad weight assessments following male sling surgery
BAUS ePoster online library. Itam S. Jun 26, 2018; 211327
Sarah Itam
Sarah Itam
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Abstract
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Introduction: Stress Urinary Incontinence (SUI) following surgery for prostate cancer or benign prostate disease can be disabling for patients. The male sling can be an effective treatment option in men with SUI. The aim of this study was to assess levels of agreement between change in ICIQ-UI-SF scores and PGIC questionnaire scores.

Method: We retrospectively reviewed our prospectively acquired database of all patients who had a male (AdVance) sling inserted between January 2012 and December 2015. Preoperative ICIQ-UI -SF questionnaires were completed and patients were evaluated at intervals post operatively with ICIQ-UI-SF and PGIC questionnaires.

Results: A total of 37 patients underwent sling insertion with mean age 68.1 (range 57-78). The questionnaire response rate was 78%. The median length of follow-up was 33 months (range 11-70). 18 patients (64%) had significant improvement in their PGIC scores (PGIC 5-7), which correlated to a mean reduction in ICIQ-UI-SF score of 7.9 (5.7 to 10.0 95% CI); compared to 10 patients with minimal PGIC change (PGIC 1-4) in ICIQ-UI-SF score of 0.3 (-3.2 to 3.8 95% CI). In addition, there is statistically significant difference in ICIQ-UI-SF question 3 (frequency of leak) and question 5 (impact on QOL) between the two groups.

Conclusion: There is good agreement between PGIC and ICIQ-UI-SF questionnaires and both can identify patients who have improved following surgery. The subjective perception of volume of urine leak doesn't appear to be a reliable outcome measure indicative of poor reliability of pad weight testing.
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