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International Urogynecology Journal

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01-01-2021 | Obesity | Original Article

Impact of severe obesity on long-term success and complications of the retropubic midurethral sling

Authors: Nicola Dykes, Lynsey Hayward, Christin Coomarasamy

Published in: International Urogynecology Journal | Issue 1/2021

Abstract

Introduction and hypothesis

With conflicting evidence in the literature, we hypothesised that the long-term subjective outcomes of the retropubic midurethral sling (MUS) are the same in the severely obese and non-obese populations.

Methods

A retrospective matched cohort study was performed on women with a BMI ≥ 35 and < 30 who had a retropubic MUS placed between 2010 and 2015 using telephone questionnaires. The primary outcome was the success rate of surgery defined by the Urogenital Distress Inventory Short Form (UDI-6) stress subscale. Statistical analysis was performed to test for associations between primary and secondary outcomes across the two groups.

Results

Seventy-eight severely obese (SOG) and 74 non-obese (NOG) were recruited. At a median time from surgery of 3.8 years the success rate was 47.4% in the SOG compared to 64.9% in the NOG (p = 0.03). There was a 22% reduction in the odds of success with every 5 unit increase in BMI (p = 0.03). There were higher rates of mixed urinary incontinence preoperatively (60.3% vs. 37.8%, p = 0.006) and persistent urinary urge incontinence postoperatively (48.7% vs. 32.4% p = 0.04) in the severely obese. Lower PGI-I scores were obtained in the severely obese group indicating less improvement in symptoms from surgery. There was no difference in complication rates between the groups.

Conclusion

Long-term subjective outcomes from the retropubic MUS are lower in severely obese women than in non-obese women with no difference in complication rates. High satisfaction and recommendation rates were found in both groups.

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Title: Impact of severe obesity on long-term success and complications of the retropubic midurethral sling
Authors: Nicola Dykes
Lynsey Hayward
Christin Coomarasamy
Publication date: 01-01-2021
Publisher: Springer International Publishing
Keywords: Obesity
Obesity
Stress Incontinence
Urge Incontinence
Urinary Incontinence
Urinary Incontinence
Published in: International Urogynecology Journal / Issue 1/2021
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-020-04414-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of severe obesity on long-term success and complications of the retropubic midurethral sling

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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