The development of a national database of the results of surgery for urinary incontinence in women

Objective To describe the development of a national network, database and reporting of data from a short-form questionnaire recording the severity of symptoms, quality of life and objective outcome values pre- and post-operatively, in women with stress and mixed incontinence. Design A prospective descriptive study. Setting Twenty-three Norwegian departments of gynaecology. Participants Eight hundred and eighty-three women with stress and mixed incontinence. Methods A short-form questionnaire was used to record the severity of symptoms, quality of life and objective outcome values pre- and post-operatively, in women with stress and mixed incontinence. Type of operation, the performance of a combined vaginal prolapse operation and an incontinence procedure and complications were recorded. The questionnaires were scanned and data were transferred to a national database. Twice a year the participating departments received a report where their own data were compared with the national average. Main outcome measures Pre- and post-operative Stress, Urge and Quality of Life Indices. Satisfaction with the operation. Post-operative mean Stress, Urge and Quality of Life Indices, leakage during stress test, and satisfaction with the operation, related to number of operations performed by each surgeon. Results Eighty-four percent of the operations performed were with the tension-free vaginal tape operation and 13% were abdominal Burch colposuspensions. The post-operative Stress and Urge Incontinence Indices and Quality of Life Index and all the objective outcome values except for the mean voiding volume were significantly lower than they were pre-operatively. Eighty-four percent of the women were very satisfied, 8% were moderately satisfied, 2% were neither satisfied nor dissatisfied, 3% were moderately dissatisfied and 2% were very dissatisfied with the operation. Women who had a tension-free vaginal tape operation performed were significantly more satisfied, were leaking significantly less, had significantly lower stress incontinence and quality of life indices and had significantly less superficial infections post-operatively than women who had had a Burch colposuspension. Surgeons performing fewer than 25 operations had a large variation in their results. Conclusion A large number of Norwegian gynaecological departments are reporting to the database. The questionnaire and the objective outcome values are well suited to record the effect of incontinence operations and to make comparisons between surgical procedures, surgeons and departments.