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World Journal of Urology

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01-08-2013 | Original Article

Clinical impact of body mass index on the outcome of the SPARC-sling system for the treatment of female stress urinary incontinence

Authors: Badereddinn Mohamad Al-Ali, Georg C. Hutterer, Erika Puchwein, Karl Pummer, Giacomo Novara, Günter Primus

Published in: World Journal of Urology | Issue 4/2013

Abstract

Purpose

Of this observational study was to evaluate the clinical outcome of the suprapubic arc (SPARC)-sling system in women with stress urinary incontinence according to body mass index (BMI).

Materials and methods

A total of 151 women underwent SPARC between June 2001 and March 2009 at a single tertiary academic center. A complete urodynamic investigation was performed preoperatively. A minimum follow-up of 12 months was required, which left data of 93 individuals for analyses. Participants were divided into the following: A, non-obese (BMI 18.5 to <25 kg/m²), B, overweight (BMI 25 to <30 kg/m²), and C, obese (BMI 30–35 kg/m²). Objective and subjective cure rates, as well as overall success rate and self-perceived severity of bother, were measured. Moreover, participants were asked about their satisfaction after surgery.

Results

Median follow-up was 7.6 years. Mean number of pads/day, pad test, and self-perceived severity of bother were significantly reduced overall, as well as in each BMI category (P < 0.001). In multivariable analyses, BMI was not an independent predictor of objective cure rate, coded either as continuous (P = 0.108) or as categorical variable (P for trend 0.301). Similarly, BMI was not an independent predictor of subjective cure rate, both coded as continuous (P = 0.475) and as categorical variable (P for trend 0.690). Overall, 92% (A), 85% (B), and 80% (C) of participants were satisfied with the surgical outcome at follow-up, respectively.

Conclusions

BMI failed to achieve independent predictor status regarding objective and subjective cure rate at follow-up. A high BMI is not a contraindication to SPARC, more studies are recommended to confirm these findings.

Ogden CL, Carroll MD, Curtin LR et al (2006) Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 295:1549PubMedCrossRef

Flegal KM, Carroll MD, Ogden CL et al (2010) Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303:235PubMedCrossRef

Seidell JC (2005) Epidemiology of obesity. Semin Vasc Med 5:3PubMedCrossRef

Micciolo R, Di Francesco V, Fantin F et al (2010) Prevalence of overweight and obesity in Italy (2001–2008): is there a rising obesity epidemic? Ann Epidemiol 20:258PubMedCrossRef

http://www.who.int/mediacentre/factsheets/fs311/en/index

Kelleher CJ, Cardozo LD, Toozs-Hobson PM (1995) Quality of life and urinary incontinence. Curr Opin Obstet Gynecol 7:404PubMedCrossRef

Schmidbauer J, Temml C, Schatzl G et al (2001) Risk factors for urinary incontinence in both sexes: analysis of a health screening project. Eur Urol 39:565PubMedCrossRef

Alling Møller L, Lose G, Jørgensen T (2000) Risk factors for lower urinary tract symptoms in women 40–60 years of age. Obstet Gynecol 96:446PubMedCrossRef

Hannestad YS, Rortveit G, Daltveit AK et al (2003) Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT study. BJOG 110:247PubMedCrossRef

10.

Richter HE, Burgio KL, Brubaker L et al (2005) Factors associated with incontinence frequency in a surgical cohort of stress incontinent women. Am J Obstet Gynecol 193:2088PubMedCrossRef

11.

Richter HE, Burgio KL, Clements RH et al (2005) Urinary and anal incontinence in morbidly obese women considering weight loss surgery. Obstet Gynecol 106:1272PubMedCrossRef

12.

Melville JL, Katon W, Delaney K et al (2005) Urinary incontinence in US women: a population-based study. Arch Intern Med 165:537PubMedCrossRef

13.

Ulmsten U, Petros P (1995) Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 29:75PubMedCrossRef

14.

Delorme E (2001) Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 11:1306PubMed

15.

Deval B, Levardon M, Samain E et al (2003) A French multicenter clinical trial of SPARC for stress urinary incontinence. Eur Urol 44:254PubMedCrossRef

16.

Roumeguère T, Quackels T, Bollens R et al (2005) Trans-obturator vaginal tape (TOT) for female stress incontinence: 1 year follow-up in 120 patients. Eur Urol 48:805PubMedCrossRef

17.

Rapp DE, Kobashi KC (2008) The evolution of midurethral slings. Nat Clin Pract Urol 5:194PubMedCrossRef

18.

Wang AC (2004) The techniques of trocar insertion and intraoperative urethrocystoscopy in tension-free vaginal taping: an experience of 600 cases. Acta Obstet Gynecol Scand 83:293PubMed

19.

Novara G, Galfano A, Boscolo-Berto R et al (2008) Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices. Eur Urol 53:288PubMedCrossRef

20.

Hellberg D, Holmgren C, Lanner L et al (2007) The very obese woman and the very old woman: tension-free vaginal tape for the treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 18:423PubMedCrossRef

21.

Deffieux X, Donnadieu AC, Porcher R et al (2007) Long-term results of tension-free vaginal tape for female urinary incontinence: follow up over 6 years. Int J Urol 14:521PubMedCrossRef

22.

Lee KS, Choo MS, Doo CK et al (2007) The long term (5-years) objective TVT success rate does not depend on predictive factors at multivariate analysis: a multicentre retrospective study. Eur Urol 53:176PubMedCrossRef

23.

Liu PE, Su CH, Lau HH et al (2011) Outcome of tension-free obturator tape procedures in obese and overweight women. Int Urogynecol J 22:259PubMedCrossRef

24.

Tchey DU, Kim WT, Kim YJ et al (2010) Influence of obesity on short-term surgical outcome of the transobturator tape procedure in patients with stress urinary incontinence. Int Neurourol J 14:13PubMedCrossRef

25.

Physical Status (1995) The use and interpretation of anthropometry. Report of a WHO expert committee. World Health Organ Tech Rep Ser 854:1

26.

Bump RC, Mattiasson A, Bø K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10PubMedCrossRef

27.

Heidler S, Ofner-Kopeinig P, Puchwein E et al (2010) The suprapubic arch sling procedure for treatment of stress urinary incontinence: a 5-year retrospective study. Eur Urol 57:897PubMedCrossRef

28.

Hahn I, Fall M (1991) Objective quantification of stress urinary incontinence: a short, reproducible provocative pad-test. Neurourol Urodyn 10:475CrossRef

29.

Hunskaar S (2008) A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women. Neurourol Urodyn 27:749PubMedCrossRef

30.

Lovatsis D, Gupta C, Dean E et al (2003) Tension-free vaginal tape procedure is an ideal treatment for obese patients. Am J Obstet Gynecol 189:1601PubMedCrossRef

31.

Skriapas K, Poulakis V, Dillenburg W et al (2006) Tension-free vaginal tape (TVT) in morbidly obese patients with severe urodynamic stress incontinence as last option treatment. Eur Urol 49:544PubMedCrossRef

32.

Mukherjee K, Constantine G (2001) Urinary stress incontinence in obese women: tension-free vaginal tape is the answer. BJU Int 88:881PubMedCrossRef

33.

Rafii A, Daraï E, Haab F et al (2003) Body mass index and outcome of tension-free vaginal tape. Eur Urol 43:288PubMedCrossRef

34.

Dunivan GC, Connolly A, Jannelli ML et al (2009) Body mass index as a risk factor for cystotomy during suprapubic placement of mid-urethral slings. Int Urogynecol J Pelvic Floor Dysfunct 20:1127PubMedCrossRef

35.

http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm262435.htm

Title: Clinical impact of body mass index on the outcome of the SPARC-sling system for the treatment of female stress urinary incontinence
Authors: Badereddinn Mohamad Al-Ali
Georg C. Hutterer
Erika Puchwein
Karl Pummer
Giacomo Novara
Günter Primus
Publication date: 01-08-2013
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 4/2013
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-011-0805-x

2024 ASCO Annual Meeting

Springer Medicine

Clinical impact of body mass index on the outcome of the SPARC-sling system for the treatment of female stress urinary incontinence

Abstract

Purpose

Materials and methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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