A randomized controlled trial evaluating the effect of an educational video on patient understanding of midurethral sling

OBJECTIVE: The primary objective was to evaluate the use of a novel video about midurethral sling surgery for enhancing patient knowledge, compared to standard educational handout. Secondary objectives were to compare post‐operative urinary incontinence outcomes, satisfaction with decision, and regret between groups. METHODS: In this dual center randomized controlled trial, women scheduled for midurethral sling were randomized to one of two educational interventions, either a novel video or standard handout. The primary outcome was change in knowledge measured via a 15‐question knowledge questionnaire completed before and after the intervention. Baseline validated urinary incontinence questionnaires were completed. Secondary outcomes were knowledge retention, urinary symptoms, decision satisfaction and regret measured via validated questionnaires, completed at 2‐and 6weeks post‐operative.Data are presented asmedian (interquartile range) and comparisons made using non‐parametric statistics between intervention groups. RESULTS: Thirty‐eight women, 19 per site, were randomized from August 2019 to October 2020 and 37 completed the primary outcome per protocol. The median age was 51 (18) years, 19 (50%) were non‐HispanicWhite, 13 (34%) Hispanic, and 6 (16%) Asian. There were no significant demographic differences between groups. Thirty‐two women underwent midurethral sling, including 31 (97%) retropubic and 1 (3%) transobturator. Participants randomized to educational video demonstrated greater change in knowledge than those randomized to handout (+8.5 (3) vs +2.0 (4), P < 0.0001). There were no differences in decision regret (1.0 (0.5) video vs 1.0 (0.8) handout, P = 0.80)) or satisfaction with decision (5.0 (0) video vs 5.0 (0.9) handout, P = 0.48) at 6‐weeks postoperative. Patients randomized to educational video demonstrated improved post‐operative urinary symptoms compared to handout (Urogenital Distress Inventory‐6 0.0 (8.3) vs 14.6 (26.0) P = 0.02; Incontinence Severity Index 0.0 (2) vs 3.0 (4), P = 0.005. CONCLUSIONS: An original educational video used to enhance surgical consent improved knowledge and urinary symptoms after midurethral sling compared to a standard handout.