Understanding the Graphs
We have attempted to indicate the quality of data entry for stress urinary incontinence by comparing the returns with Hospital Episode Statistics (HES data) - this is information collected by every NHS hospital after a patient’s discharge from a surgical procedure. Unfortunately, HES data are not 100% reliable but ideally, all procedures recorded on HES will be entered by the surgeon on to the BAUS database for analysis. A coding percentage close to 100% suggests good recording; a percentage higher than this may indicate incorrect HES coding of procedures at the individual surgeon's hospital and a low percentage suggests incomplete recording by the surgeon or, again, poor HES coding.
Number of Operations
The number of operations indicates the total number of procedures carried out by each surgeon for female stress urinary incontinence. This includes mid-urethral synthetic tapes, colposuspension, periurethral bulking agents and autologous sling procedures.
The data represents approximately 72% of the total procedures for stress urinary incontinence carried out by urologists in England in 2015, 2016 and 2017.
Patient Reported Outcome Measures
1. ICIQ-UI Short Form Questionnaire
The ICIQ-UI Short Form is a patient-reported outcome measure (PROM) which assesses the impact of symptoms of incontinence on quality of life and outcome of treatment (download the questionnaire). Patients complete the form at the time of initial assessment, or prior to surgery, to record the level and impact of their symptoms of incontinence; they then repeat the questionnaire at follow-up, three months after the procedure.
The data presented here show the improvement in the patient’s perception of the change in severity of symptoms using the ICIQ-UI Short Form. The ICIQ-UI Short Form is an standard questionnaire used internatiolnally to assess urinary symptoms.
The health score categories are recorded as percentages improved, unchanged or worsened.
2. Pad Use Per Day (PPD)
Pad use per day (PPD) is a method of measuring urinary incontinence. The number of pads used per day is recorded, as stated by the patient before and after surgery, to indicate the severity of their incontinence.
Pad usage categories are recorded as percentages improved, unchanged or worsened in severity. PPD usage is not reported for all patients who have undergone a procedure for stress urinary continence. PPD is a method of measuring urinary incontinence but, as noted above, not all patients are asked to report on PPD usage, and not all patients who are asked actually comply.
N.B. PROMs are highly subjective measurements: there is, therefore, a significant chance of variations between patients in the assessment of symptoms and outcomes