Preoperative anxiety and fear: what concerns women with stress urinary incontinence?

Introduction. Stress urinary incontinence (SUI) is a common condition that can significantly impair women’s quality of life. Despite the proven efficacy of sling procedures, preoperative fears among patients remain an understudied topic, although such fears may affect treatment outcomes and patient satisfaction.

Objective. To investigate preoperative fears among women with SUI and identify factors associated with these concerns.

Materials & methods. The study included 720 women diagnosed with SUI who were scheduled to undergo sling surgery. Preoperative fears were assessed using a custom-developed questionnaire, along with the Hospital Anxiety and Depression Scale (HADS).

Results. Preoperative fears were reported by 77% of women with SUI. The most frequently reported concerns were persistent urinary leakage requiring continued use of pads (45.1%), complications related to the implant (30.4%), and anesthesia-related fears (25.8%). Women with preoperative fears were significantly more likely to be married (71.0% vs. 62.3%; p = 0.039) and to have undergone previous pelvic reconstructive surgery (45.8% vs. 36.4%; p = 0.037). Higher preoperative anxiety and depression levels on the HADS were associated with a greater number of fears. Fear of implant-related complications was more prevalent among women under 60, with higher education, employed, and residing in urban areas. Fear of anesthesia was more common in employed and previously non-operated women. Fear of persistent symptoms was more frequent among married women and those with a history of reconstructive surgery. Multivariate logistic regression identified marital status, presence of depression, and place of residence as independent predictors of preoperative fears.

Conclusion. Identifying and understanding the nature of preoperative fears in women with SUI may help optimize preoperative counseling and psychological preparation, potentially improving postoperative outcomes.

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