The Role of Obesity in Success and Complications in Patients Undergoing Retropubic Tension-Free Vaginal Tape Surgery

Berger, A; Montella, Joseph M.

doi:10.1097/01.ogx.0000491199.34639.a7

Cited by 3 publications

(6 citation statements)

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“…16 The risk factors associated with bladder perforation in our study were same as reported in literature i.e., high BMI and previous pelvic surgery. 17,18 We found 5% Voiding Dysfunction (VD) in Burch and 1.7% in TVT group, similar to results observed in a recent systematic review. 14 A similar retrospective study found 6.1% short term VD with TVT and 7.9% with Burch 16 but among the MUS; TVT was associated with long-term-VD.…”

Section: Disscusionsupporting

confidence: 89%

The practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country

2021

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Objectives: To compare the effectiveness and complications of Burch colposuspension and Mid Urethral Slings (MUS) for the treatment of Stress Urinary Incontinence (SUI). Methods: We conducted a cross-sectional study of 162 patients who underwent surgery for SUI with Burch colposuspension (n=40), tension free vaginal tape (TVT) (n= 59) or transobturator tape (TOT) (n=63), from 2006 to 2014 at the Aga Khan University Hospital- Karachi. All three groups were assessed in terms of demographics, cure rates, intraoperative and postoperative complications at one and five years using incontinence impact questionnaire-short form-7 (IIQ-7) and urogenital distress inventory -short form-6 (UDI-6). Results: Mean age of the participants in Burch, TVT and TOT group was 44.1 ± 7.4, 48.3 ± 8.9, 53.0 ± 9.4 respectively. Majority of patients in TVT group were premenopausal (59.3%) and postmenopausal in TOT group (53.9%). Most abdominal hysterectomies were done in Burch group (40) while vaginal hysterectomies and anterior and posterior colporrhaphy in TOT group (55). All the procedures had both subjective and objective cure rate of more than 82% at one year, with TVT having the highest success rate of 96.61%. The objective cure rate in Burch, TVT and TOT group at five years was 74.19%, 90.30% and 81.25% respectively. Intraoperative complications included hemorrhage in one patient during Burch procedure and bladder perforation in two cases of TVT, with no significant difference in short or long-term complications with either procedure. Conclusions: All the three procedures have equal efficacy and complication rates. Even though TVT is the new gold standard but in view of current debate regarding mesh related complications, there is a need to readdress Burch colposuspension for treatment of SUI. doi: https://doi.org/10.12669/pjms.37.5.4017 How to cite this:Abrar S, Razzak L, Mohsin R. The practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4017 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Disscusionsupporting

confidence: 89%

The practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country

2021

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“…10 McKenna et al 24 followed a cohort of women for 5 years who underwent retropubic sling procedures and found significantly worse subjective and objective results in obese patients (98% vs 71%, P = .004). Berger et al 25 in a retrospective cohort of retropubic TVT subjects, found that obese women had…”

Section: Discussionmentioning

confidence: 99%

“…McKenna et al 24 followed a cohort of women for 5 years who underwent retropubic sling procedures and found significantly worse subjective and objective results in obese patients (98% vs 71%, P = .004). Berger et al 25 in a retrospective cohort of retropubic TVT subjects, found that obese women had 3.5‐fold increased odds of short term SUI complaints compared with nonobese women (2 weeks after surgery). Similar findings were reported when a single incision sling is used 26 .…”

Section: Discussionmentioning

confidence: 99%

Obesity as a risk factor for poor outcomes after sling surgery in women with stress urinary incontinence: A systematic review and meta‐analysis

Barco‐Castillo

Zuluaga

Serrano

et al. 2020

Neurourology and Urodynamics

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Obesity is one of the main risk factors for stress urinary incontinence (SUI) and has also been associated with worse surgical outcomes. However, the literature is heterogeneous and inconclusive. The goal of this study was to perform a systematic review and meta-analysis to evaluate cure rates and perioperative complications in obese women. Materials and Methods: A literature search of OVID, MEDNAR, Embase, Scopus, Web of Science, PubMed, and CENTRAL databases was conducted. Randomized controlled trials comparing cure rates and failure of treatment in normal and obese patients, who underwent mid-urethral sling surgery, were identified. A systematic review of subjective and objective cure rates, and complications was performed. Meta-analyses of dichotomous data under the random-effects model were applied using Review Manager 5.3. Nonrandomized comparative studies and gray literature were excluded. Results: A total of 219 studies were identified. Four randomized controlled trials were included for evaluation. The risk of bias evaluation was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. One study was excluded due to missing data on the outcomes. Patients were stratified according to their body mass index as obese (>30 kg/m 2) and nonobese (<30 kg/m 2). Complications could not be meta-analyzed. The meta-analysis of subjective (risk ratio [RR] = 1.69 [95% confidence interval [CI]: 1.32-2.16]) and objective (RR = 1.62 [95% CI: 1.26-2.07]) cure rates disfavored obese women. Conclusions: This meta-analysis shows that obesity is a risk factor for the nonsuccessful treatment of SUI with tension-free mid-urethral sling. Differences in regards to the surgical approach and its association with obesity could not be established with the current evidence.

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“…Obesity is an increasing health problem, and some epidemiological studies have identified a positive association between obesity and an increased prevalence of SUI (5,6). Although weight loss may be beneficial to obese patients with SUI, definitive treatment may be best obtained through surgical intervention (6). Many techniques to correct SUI have been described over the years.…”

Section: Introductionmentioning

confidence: 99%

“…Obesity is one of the critical risk factors for the development of urinary incontinence with age as well as pregnancy, childbirth, and reduced collagen turnover (2)(3)(4). Obesity is an increasing health problem, and some epidemiological studies have identified a positive association between obesity and an increased prevalence of SUI (5,6). Although weight loss may be beneficial to obese patients with SUI, definitive treatment may be best obtained through surgical intervention (6).…”

Section: Introductionmentioning

confidence: 99%

Increased Body Mass Index and Success Rate of Tension-free Tape Surgery

Dağdeviren

Cengiz

Süzen

et al. 2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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Objective: Only limited data are available on the outcome of tension-free obturator tape (TOT) procedures in overweight and obese women. This study aimed to assess the impact of body mass index (BMI) on TOT success rates, patient acceptability, and complications 1-year post-surgery. Material and Methods: 96 women who suffered from stress urinary incontinence (SUI) underwent the TOT procedure were included to this prospective cohort study. Patients were followed for at least one year. Patients were divided into three different groups related to BMI according to the World Health Organization (WHO) classification; Group 1 (healthy BMI <25 kg/m2), Group 2 (overweight BMI 25-30 kg/m2), Group 3 (obese BMI > 30 kg/m 2). The subjective and objective outcomes, complications, and quality of life were assessed by validated questionnaires (UDI-6, IIQ-7). The results were compared for each group. Results: Of the 96 women, 32 were defined as having a healthy weight, 32 were overweight, and 32 were obese. The complication rate was not significantly different between the BMI groups (p>0.05). The UDI-6 and IIQ-7 scores at a one-year follow-up showed a significant reduction versus baseline in each group without significant differences between the BMI groups. The overall objective cure rate was 80.2% (77 out of 96) by 1-hour pad test and cough test (71.8% in group 1 and 84.3% in groups 2 and 3). There were no significant differences between the groups. Conclusion: TOT procedure has similar objectives and subjective cure rates among all the BMI groups. Elevated BMI does not increase the complication rate.

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The Role of Obesity in Success and Complications in Patients Undergoing Retropubic Tension-Free Vaginal Tape Surgery

Cited by 3 publications

References 0 publications

The practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country

The practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country

Obesity as a risk factor for poor outcomes after sling surgery in women with stress urinary incontinence: A systematic review and meta‐analysis

Increased Body Mass Index and Success Rate of Tension-free Tape Surgery

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