One of the major goals of this project is to determine the long term effects and outcomes including complications of the' most commonly used surgical procedures for urinary incontinence. Extensive review of the literature shows that the success rate (continence) and improvement rate appear to be similar among all of the three surgical techniques proposed in this CTC. Although the complications may be more unique with one or the other, it also appears that the morbidity rate is similar. Therefore, we do not believe that a power calculation can be performed to estimate the total number of subjects needed to be enrolled in each group. Therefore, we believe that the total number of subjects may have to be arbitrarily decided by the network to assure an adequate number of patients to be observed to gather all the necessary information to satisfy the objectives of this study. The principal goal of incontinence therapy is to improve the quality of life for the patient. Patient satisfaction in long-term follow-up has not been adequately reported in the literature. This study can provide the extensive review of these issues. However, the criteria on which the comparisons are made will necessarily be agreed upon by the collective investigators. In addition, the economics of the proposed procedures will also have a bearing on the overall medicoeconomic outcomes. Due to the similarities between the reported treatment success rates, differences in long term cost effectiveness and ultimate patient satisfaction may be a better predictor of overall treatment success than improvement of incontinence symptoms alone.
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