Is Obesity a Risk Factor for Failure and Complications After Surgery for Incontinence and Prolapse in Women?

Abstract

Although cure rates are lower, obese women have significant improvements in quality of life after surgery for stress urinary incontinence. Obesity does not appear to be a risk factor for additional complications during sling and prolapse surgery.

The impact of obesity on outcomes and complications after top‐down retropubic midurethral sling

“…In terms of postoperative voiding, a significantly greater percentage of women in the obese group passed their initial voiding trial following surgery. We have previously postulated that the obese woman has an increased intra‐abdominal pressure at rest and with daily activities, and, thus, may facilitate earlier and more efficient voiding . Indeed, obesity was associated with lower, albeit not statistically significant, rates of CIC and sling release.…”

“…The outcomes of surgical intervention in the obese woman with SUI are just starting to emerge. Haverkorn et al demonstrated that overall cure rates for SUI were lower in obese women than their non‐obese counterparts undergoing transobturator midurethral slings (MUS) and bladder neck slings constructed from autologous or porcine tissue; however, both groups experienced similar improvement in quality of life (QoL) following surgery . While several surgical modifications to the MUS have been introduced, the retropubic midurethral sling (RPM) introduced in 1996 is considered a gold standard for the surgical treatment of SUI .…”

Twelve‐month outcomes following midurethral sling procedures for stress incontinence: impact of obesity

“…Knowledge of these factors would allow physicians to provide better preoperative counselling to those likely to have suboptimal outcomes. One patient characteristic that may predict surgical outcome is body mass index (BMI) . It is thought that obesity may place additional pressure on the pelvic floor and sling causing the procedure to function less optimally …”

Incontinence urinaire et obésité

“…La série de Killingsworth et al confirment ces données en retrouvant des taux de complications identiques quel que soit le statut pondéral [39]. De plus, une série rétros-pective récente de 709 femmes opérées pour prolapsus ou IU ne retrouve pas d'excès de complications peropéra-toires ou postopératoires chez les patientes obèses par rapport aux non obèses [44]. Seules les données de la série de Skriapias et al, retrouvent un taux plus important de complications précoces graves, (notamment cardiovasculaires, thrombo-emboliques.…”