Quality of life

Urinary incontinence is a common and distressing condition known to adversely affect quality of life [22]. Research has often concentrated on the prevalence, aetiology, diagnosis and management of urinary incontinence with little work being performed on the effects of this chronic condition, or its treatment, on quality of life (QoL). Over the last few decades interest in the incorporation of patient assessed health status or QoL measures into the evaluation of the management of urinary incontinence has increased [23].

The views of clinicians and patients regarding QoL and the effects of treatments differ considerably. Consequently there is increased recognition of the patients' perception when assessing new interventions in the management of lower urinary tract dysfunction. The measurement of QoL allows the quantification of morbidity, the evaluation of treatment efficacy and also acts as a measure of how lives are affected and coping strategies adopted. It is estimated that 20% of adult women suffer some degree of life disruption secondary to lower urinary tract dysfunction [24].

The World Health Organisation has defined health as 'not merely the absence of disease, but complete physical, mental and social well-being' [25]. Quality of life has been used to mean a combination of patient assessed measures of health including physical function, role function, social function, emotional or mental state, burden of symptoms and sense of well-being [26]. QoL has been defined as including 'those attributes valued by patients including their resultant comfort or sense of well-being; the extent to which they were able to maintain reasonable physical, emotional, and intellectual function; the degree to which they retain their ability to participate in valued activities within the family and the community' [27]. This helps to emphasize the multidimensional nature of QoL and the importance of considering patients perception of their own situation with regard to non-health related aspects of their life [28].

Whilst quality of life is highly subjective it has now been acknowledged that it is as important as physical disease state in the management of women with lower urinary tract dysfunction [29]. Consequently the success of treatment can no longer be judged on clinical parameters alone and quality of life needs to be considered in both clinical and research settings [30].

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