The impact of obesity on outcomes and complications after top‐down retropubic midurethral sling
Aims Obese women (BMI ≥ 30 kg/m2) have been considered at higher risk for postoperative complications and failure in efficacy after SUI surgery. We compare the outcomes in this population with non‐obese women (BMI
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| Veröffentlicht in: | Neurourology and urodynamics 2017-06, Vol.36 (5), p.1330-1335 |
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| container_title | Neurourology and urodynamics |
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| creator | Karaman, Umar Campbell, Kevin J. Frilot, Clifton F. Gomelsky, Alex |
| description | Aims
Obese women (BMI ≥ 30 kg/m2) have been considered at higher risk for postoperative complications and failure in efficacy after SUI surgery. We compare the outcomes in this population with non‐obese women (BMI |
| doi_str_mv | 10.1002/nau.23098 |
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Obese women (BMI ≥ 30 kg/m2) have been considered at higher risk for postoperative complications and failure in efficacy after SUI surgery. We compare the outcomes in this population with non‐obese women (BMI < 30 kg/m2) undergoing top‐down retropubic polypropylene midurethral sling (RPM).
Methods
We retrospectively identified 328 non‐obese women and 294 obese women who underwent RPM. Evaluation included SEAPI (stress incontinence, emptying, anatomy, protection, inhibition) assessment and validated QoL questionnaires. Cure was defined as absence of subjective and objective SUI and no additional procedures to correct SUI. Perioperative details were ed from the hospital and clinic charts. Groups and outcomes were statistically compared.
Results
All women had a minimum follow up of 12 months. Preoperative demographic variables, SEAPI scores, and QoL indices were similar between BMI groups. SUI cure rates were significantly higher for non‐obese women (82.9% vs. 74.5%; P < 0.01). When controlling for concomitant pelvic surgery, cure rates were not statistically different (76.9% vs. 73.7%; P = 0.65). Statistically significant improvement in SEAPI scores and QoL indices was achieved in both groups. Overall, obese women had no increase in complications compared with the non‐obese. The chance of passing an initial postoperative voiding trial was statistically higher in the obese group.
Conclusions
Obese women have similar success rates and significant improvement in QoL as non‐obese women after RPM. Obesity alone does not appear to be a risk factor for additional complications during sling surgery and obese women may have earlier return to normal voiding after surgery.</description><identifier>ISSN: 0733-2467</identifier><identifier>EISSN: 1520-6777</identifier><identifier>DOI: 10.1002/nau.23098</identifier><identifier>PMID: 27513448</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; complications ; Female ; Humans ; Middle Aged ; midurethral sling ; obesity ; Obesity - complications ; outcomes ; Postoperative Complications - etiology ; Retrospective Studies ; stress urinary incontinence ; Suburethral Slings ; Surveys and Questionnaires ; Urinary Incontinence, Stress - complications ; Urinary Incontinence, Stress - physiopathology ; Urinary Incontinence, Stress - surgery ; Urination - physiology</subject><ispartof>Neurourology and urodynamics, 2017-06, Vol.36 (5), p.1330-1335</ispartof><rights>2016 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3258-d32b6b0ff41efaa77768b7a5e1ef31bda5d1d67a963d22a3df99aab548ba88543</citedby><cites>FETCH-LOGICAL-c3258-d32b6b0ff41efaa77768b7a5e1ef31bda5d1d67a963d22a3df99aab548ba88543</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fnau.23098$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fnau.23098$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27513448$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karaman, Umar</creatorcontrib><creatorcontrib>Campbell, Kevin J.</creatorcontrib><creatorcontrib>Frilot, Clifton F.</creatorcontrib><creatorcontrib>Gomelsky, Alex</creatorcontrib><title>The impact of obesity on outcomes and complications after top‐down retropubic midurethral sling</title><title>Neurourology and urodynamics</title><addtitle>Neurourol Urodyn</addtitle><description>Aims
Obese women (BMI ≥ 30 kg/m2) have been considered at higher risk for postoperative complications and failure in efficacy after SUI surgery. We compare the outcomes in this population with non‐obese women (BMI < 30 kg/m2) undergoing top‐down retropubic polypropylene midurethral sling (RPM).
Methods
We retrospectively identified 328 non‐obese women and 294 obese women who underwent RPM. Evaluation included SEAPI (stress incontinence, emptying, anatomy, protection, inhibition) assessment and validated QoL questionnaires. Cure was defined as absence of subjective and objective SUI and no additional procedures to correct SUI. Perioperative details were ed from the hospital and clinic charts. Groups and outcomes were statistically compared.
Results
All women had a minimum follow up of 12 months. Preoperative demographic variables, SEAPI scores, and QoL indices were similar between BMI groups. SUI cure rates were significantly higher for non‐obese women (82.9% vs. 74.5%; P < 0.01). When controlling for concomitant pelvic surgery, cure rates were not statistically different (76.9% vs. 73.7%; P = 0.65). Statistically significant improvement in SEAPI scores and QoL indices was achieved in both groups. Overall, obese women had no increase in complications compared with the non‐obese. The chance of passing an initial postoperative voiding trial was statistically higher in the obese group.
Conclusions
Obese women have similar success rates and significant improvement in QoL as non‐obese women after RPM. Obesity alone does not appear to be a risk factor for additional complications during sling surgery and obese women may have earlier return to normal voiding after surgery.</description><subject>Adult</subject><subject>complications</subject><subject>Female</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>midurethral sling</subject><subject>obesity</subject><subject>Obesity - complications</subject><subject>outcomes</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>stress urinary incontinence</subject><subject>Suburethral Slings</subject><subject>Surveys and Questionnaires</subject><subject>Urinary Incontinence, Stress - complications</subject><subject>Urinary Incontinence, Stress - physiopathology</subject><subject>Urinary Incontinence, Stress - surgery</subject><subject>Urination - physiology</subject><issn>0733-2467</issn><issn>1520-6777</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kLtOxDAQRS0EYpdHwQ8gl1Bk8SOOnXKFeEkIGqijceyAURIHO9FqOz6Bb-RLMCzQUc3c0dGV5iB0RMmCEsLOepgWjJNSbaE5FYxkhZRyG82J5DxjeSFnaC_GF0KI4nm5i2ZMCsrzXM0RPDxb7LoB6hH7BnttoxvX2PfYT2PtOxsx9AanbWhdDaPzfbo0ow149MPH27vxqx4HOwY_TNrVuHNmSvE5QItj6_qnA7TTQBvt4c_cR4-XFw_n19nt_dXN-fI2qzkTKjOc6UKTpsmpbQDSA4XSEoRNkVNtQBhqCgllwQ1jwE1TlgBa5EqDUiLn--hk0zsE_zrZOFadi7VtW-itn2JFlSglTaBI6OkGrYOPMdimGoLrIKwrSqovo1UyWn0bTezxT-2kO2v-yF-FCTjbACvX2vX_TdXd8nFT-QkZHYMH</recordid><startdate>201706</startdate><enddate>201706</enddate><creator>Karaman, Umar</creator><creator>Campbell, Kevin J.</creator><creator>Frilot, Clifton F.</creator><creator>Gomelsky, Alex</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201706</creationdate><title>The impact of obesity on outcomes and complications after top‐down retropubic midurethral sling</title><author>Karaman, Umar ; Campbell, Kevin J. ; Frilot, Clifton F. ; Gomelsky, Alex</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3258-d32b6b0ff41efaa77768b7a5e1ef31bda5d1d67a963d22a3df99aab548ba88543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>complications</topic><topic>Female</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>midurethral sling</topic><topic>obesity</topic><topic>Obesity - complications</topic><topic>outcomes</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>stress urinary incontinence</topic><topic>Suburethral Slings</topic><topic>Surveys and Questionnaires</topic><topic>Urinary Incontinence, Stress - complications</topic><topic>Urinary Incontinence, Stress - physiopathology</topic><topic>Urinary Incontinence, Stress - surgery</topic><topic>Urination - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karaman, Umar</creatorcontrib><creatorcontrib>Campbell, Kevin J.</creatorcontrib><creatorcontrib>Frilot, Clifton F.</creatorcontrib><creatorcontrib>Gomelsky, Alex</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neurourology and urodynamics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karaman, Umar</au><au>Campbell, Kevin J.</au><au>Frilot, Clifton F.</au><au>Gomelsky, Alex</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of obesity on outcomes and complications after top‐down retropubic midurethral sling</atitle><jtitle>Neurourology and urodynamics</jtitle><addtitle>Neurourol Urodyn</addtitle><date>2017-06</date><risdate>2017</risdate><volume>36</volume><issue>5</issue><spage>1330</spage><epage>1335</epage><pages>1330-1335</pages><issn>0733-2467</issn><eissn>1520-6777</eissn><abstract>Aims
Obese women (BMI ≥ 30 kg/m2) have been considered at higher risk for postoperative complications and failure in efficacy after SUI surgery. We compare the outcomes in this population with non‐obese women (BMI < 30 kg/m2) undergoing top‐down retropubic polypropylene midurethral sling (RPM).
Methods
We retrospectively identified 328 non‐obese women and 294 obese women who underwent RPM. Evaluation included SEAPI (stress incontinence, emptying, anatomy, protection, inhibition) assessment and validated QoL questionnaires. Cure was defined as absence of subjective and objective SUI and no additional procedures to correct SUI. Perioperative details were ed from the hospital and clinic charts. Groups and outcomes were statistically compared.
Results
All women had a minimum follow up of 12 months. Preoperative demographic variables, SEAPI scores, and QoL indices were similar between BMI groups. SUI cure rates were significantly higher for non‐obese women (82.9% vs. 74.5%; P < 0.01). When controlling for concomitant pelvic surgery, cure rates were not statistically different (76.9% vs. 73.7%; P = 0.65). Statistically significant improvement in SEAPI scores and QoL indices was achieved in both groups. Overall, obese women had no increase in complications compared with the non‐obese. The chance of passing an initial postoperative voiding trial was statistically higher in the obese group.
Conclusions
Obese women have similar success rates and significant improvement in QoL as non‐obese women after RPM. Obesity alone does not appear to be a risk factor for additional complications during sling surgery and obese women may have earlier return to normal voiding after surgery.</abstract><cop>United States</cop><pmid>27513448</pmid><doi>10.1002/nau.23098</doi><tpages>6</tpages></addata></record> |
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| ispartof | Neurourology and urodynamics, 2017-06, Vol.36 (5), p.1330-1335 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult complications Female Humans Middle Aged midurethral sling obesity Obesity - complications outcomes Postoperative Complications - etiology Retrospective Studies stress urinary incontinence Suburethral Slings Surveys and Questionnaires Urinary Incontinence, Stress - complications Urinary Incontinence, Stress - physiopathology Urinary Incontinence, Stress - surgery Urination - physiology |
| title | The impact of obesity on outcomes and complications after top‐down retropubic midurethral sling |
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