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International Urogynecology Journal
Published in: International Urogynecology Journal 6/2017

01-06-2017 | Review Article

Does body mass index influence the outcome of midurethral sling procedures for stress urinary incontinence?

Authors: Ziyuan Xia, Jialei Qian, Yuntian Chen, Banghua Liao, Deyi Luo

Published in: International Urogynecology Journal | Issue 6/2017

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Abstract

Introduction and hypothesis

Whether midurethral sling (MUS) procedures are as effective in obese women as they are in women of normal weight is still a matter of controversy. The objective of this study was to determine if body mass index (BMI) influences the outcome of MUS procedures for stress urinary incontinence (SUI).

Methods

We searched electronic databases including EMBASE, MEDLINE, Web of Science and Ovid evidence-based medicine reviews to identify studies that explored the association between BMI and outcomes of MUS procedures. The studies were rated using the Newcastle-Ottawa scale; the meta-analysis was performed using Review Manager 5.3 software.

Results

This review included 11 studies, 6 prospective cohort studies and 5 retrospective studies, with a total of 2,846 patients. The objective success rates of MUS in patients with BMI >25 kg/m2 (overweight and obese) were lower than in patients with BMI 18.5 – <25 kg/m2 (normal weight; RR = 0.93, 95 % CI 0.89 – 0.97; P = 0.002). The objective success rates were not significantly different between the overweight group (BMI 25 – <30 kg/m2) and the obese group (BMI ≥30 kg/m2; RR = 0.95, 95 % CI 0.89 – 1.01; P = 0.08). There were no significant differences in subjective outcomes among the different BMI groups: BMI ≥25 kg/m2 versus 18.5 – <25 kg/m2 (RR = 1.03, 95 % CI 0.97 – 1.10; P = 0.29), and BMI ≥30 kg/m2 versus 25 – <30 kg/m2 (RR = 0.98, 95 % CI 0.92 – 1.04; P = 0.55).

Conclusions

The objective success rates of MUS were lower in overweight and obese patients; however, the subjective outcomes of MUS were not significantly different among normal weight, overweight and obese patients. The MUS procedure is as effective in obese women as in women of normal weight, and therefore surgeons should not consider BMI >25 kg/m2 as a risk factor when discussing the suitability of the MUS procedure in a patient with SUI.
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Metadata
Title
Does body mass index influence the outcome of midurethral sling procedures for stress urinary incontinence?
Authors
Ziyuan Xia
Jialei Qian
Yuntian Chen
Banghua Liao
Deyi Luo
Publication date
01-06-2017
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 6/2017
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-016-3181-7

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