OBJECTIVE: To evaluate impact of body mass index (BMI) ≥30 on objective and subjective cure rates 12 months after midurethral sling surgery.
DESIGN: Secondary analysis.
SETTING: Three hospitals in Calgary, Canada, 2005-07.
POPULATION: A total of 182 women enrolled in a randomised control trial of tension-free vaginal tape versus transobturator tape.
METHODS: Women were classified as obese or nonobese from height and weight on day of surgery. Women underwent postoperative standardised pad tests, self-reporting of urinary incontinence, and quality of life scores. Categorical data compared with chi-square or Fisher's exact, continuous data compared with Mann-Whitney U test.
MAIN OUTCOME MEASURES: Primary outcome was objective cure, defined as < 1 g urine loss on postoperative 1-hour pad test. Secondary outcomes were subjective cure of incontinence (no stress incontinence in previous 7 days), presence of urinary urgency in previous 7 days, Urogenital Distress Inventory (UDI-6) scores, Incontinence Impact Questionnaire (IIQ-7) scores, and surgical complication rates.
RESULTS: Objective cure differed, with 85.6% of nonobese women leaking < 1 g on 1-hour pad test, versus 67.8% of obese women (P = 0.006, risk difference [RD] 17.8%, 95% confidence interval (95% CI) 4.2-31.4%). Subjective cure was 85.8% for nonobese women versus 70.7% for obese women (P = 0.016, RD 15.1%, 95% CI 1.9-28.4%). For both groups, improvement was seen for postoperative UDI-6 (median -33.3 (-44.4 to -22.2) and -27.2 (-44.4 to -16.7)) and IIQ-7 scores (median -26.2 (-45.2 to -14.3) and -23.8 (-42.9 to -14.3)). No differences existed in rates of operative complications between the two groups.
CONCLUSIONS: Twelve months after midurethral sling surgery, obese women experience lower rates of cure than those who are nonobese.
Written by:
Brennand E, Tang S, Williamson T, Birch C, Murphy M, Robert M, Ross S. Are you the author?
Division of Urogynaecology, Department of Obstetrics and Gynaecology, University of Calgary, Calgary, AB, Canada.
Reference: BJOG. 2014 Oct 15. Epub ahead of print.
doi: 10.1111/1471-0528.13132
PubMed Abstract
PMID: 25316484