Influence of Obesity on Short-term Surgical Outcome of the Transobturator Tape Procedure in Patients with Stress Urinary Incontinence

Abstract

Purpose: The purpose of our study was to evaluate the influence of obesity on clinical characteristics, quality of life (QoL), and outcomes in patients with stress urinary incontinence (SUI) who underwent the transobturator tape (TOT) surgery. Materials and Methods: The medical records of SUI patients who underwent the TOT operation from January 2007 to February 2009 were retrospectively reviewed. Patients with any neurologic diseases that affect the voiding pattern were excluded, and 107 patients were enrolled. The patients were divided into nonobese (BMI<25) and obese (BMI≥25) groups. The preoperative evaluation consisted of history taking, physical examination, cystometrography, 3-day frequency-volume chart, King's Health Questionnaire (KHQ), and symptom perception scale questionnaires. Results:The nonobese group consisted of 55 (51.4%) patients and the obese group of 52 (48.6%). The median age was 49.0 (range, 30.8-73.5) years in the nonobese group and 52.7 (range, 35.5-73.5) years in the obese group (p>0.05). The obese group showed a higher SUI symptom grade, urethral hypermobility, urgency, and urge incontinence scale than did the nonobese group (each p<0.05). Neither the domains of the KHQ nor the items on the 3-day frequency-volume chart differed between the two groups (each p>0.05). After the operation, the symptom scales and parameters in the 3-day frequency-volume chart of the obese group were similar to those of the nonobese group (each p>0.05). The objective success, recurrence, and complication rates at 1year were similar in the two groups (each p>0.05). Conclusions: Obese SUI patients had worse SUI symptom grade, urgency, and urge incontinence symptoms than did nonobese patients. However, surgical correction by the TOT operation could restore the symptoms and voiding parameters as effectively in obese patients as in nonobese patients.

Do severe obese patients with stress urinary incontinence benefit from transobturator tape procedure? 3-year surgical outcome

“…15,16 Tchey and colleagues reported that obese patients had a worse grade of SUI, urgency and UUI than non-obese patients. 10 According to Richter and colleauges, a possible mechanism leading to the development of urge or UUI is obesity-induced neurogenic effects on the pelvic floor. 17 Because the obese female population has a high prevalence of SUI, these patients often present for surgical evaluation.…”

“…In these studies, midurethral sling (MUS) procedures have been effective with minimal complications in obese patients. [10][11][12] However the influence of obesity on surgical outcomes of TOT procedure is still controversial and the situation is more complicated when it comes to severely obese patients.…”

Nutukusių moterų šlapimo nelaikymo gydymas atliekant TVT operaciją Vilniaus universiteto ligoninės Santariškių klinikų urologijos centre

“…Kalbant apie nutukusių ir antsvorio turinčių moterų šlapimo nelaikymo gydymo, atliekant TVT operaciją, rezultatus, dauguma autorių rekomenduoja šį būdą kaip pasirinkimo operaciją esant nutukusioms pacientėms, nors nerado statistiškai reikšmingo rezultatų skirtumo tarp nutukusių ir normalaus svorio moterų gydymo. Tai rodytų, kad KMI dydis neturi reikšmės šlapimo nelaikymo gydymo galutiniams rezultatams, kai implantuojami pošlapliniai raiščiai [20,21,22,23,24]. 2014 m. atlikta operuotų ligonių anketinė apklausa apie šlapimo nelaikymo įtaką kasdieniam gyvenimui ir jo kokybei.…”

Incontinence urinaire et obésité

“…Plus récemment, Killingsworth rapporte un taux de satisfaction identique à un an d'une mise en place d'un TVT dans une population de 195 femmes dont 65 en surpoids et 62 obèses [39]. Concernant le TOT, Tchey et al ont démontré, sur une série rétrospective de 107 patientes dont 52 femmes avec un IMC supérieur ou égal à 25, que le taux de complications, de récidive et les résul-tats fonctionnels à un an étaient inchangés par rapport à une population de femmes de poids normal [40].…”

“…sans noter toutefois de majoration des autres complications plus spécifiques de l'intervention [42]. Concernant la voie transobturatrice, le risque de complications per-et postopératoires à un an n'apparaît pas augmenté en cas de surpoids [40].…”