Skip to main content
SpringerLink
Log in

Chirurgie de l’incontinence urinaire à l’effort chez la femme obèse

SUI surgery in obese women

  • Dossier Thématique / Thematic File
  • Published:
Obésité

Résumé

L’obésité constitue un facteur de risque clairement démontré de l’incontinence urinaire de la femme. En cas de surpoids, un programme de réduction pondérale améliore l’incontinence urinaire avec une diminution du nombre d’épisodes de fuites et peut donc être proposé en traitement de première intention. Les résultats du TVT (tension-free vaginal tape) chez les patientes obèses sont comparables à ceux obtenus chez les patientes de poids normal, et cette intervention constitue la procédure de choix pour le traitement chirurgical de l’incontinence urinaire d’effort en cas d’obésité. L’obésité ne constitue pas non plus un facteur de risque pour les complications per- et postopératoires.

Abstract

Obesity is an established risk factor for SUI. Among overweight women, a weight loss program improves urinary incontinence with a reduction in the frequency of self-reported urinary incontinence episodes and may be suggested as a first-line therapy. Success rates after TVT are similar among obese patients and normal-weight patients, and TVT is the prime procedure to treat SUI in obese patients. Obesity does not appear as a risk factor for intra- and postoperative complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. Charles MA, Basdevant A, Eschwege E (2002) Prevalence of obesity in adults in France: the situation in 2000 establishedfrom the ObEpi Study. Ann Endocrinol (Paris) 63: 154–8

    CAS  Google Scholar 

  2. Charles MA, Eschwege E, Basdevant A (2008) Monitoring the obesity epidemic in France: the ObEpi surveys 1997–2006. Obesity (Silver Spring) 16:2182–6

    Article  Google Scholar 

  3. Dwyer PL, Lee ET, Hay DM (1988) Obesity and urinary incontinence in women. Br J Obstet Gynecol 95:91–6

    CAS  Google Scholar 

  4. Elia G, Dye TD, Scariati PD (2001) Body mass index and urinary symptoms in women. Int Urogynecol J Pelvic Floor Dysfunct 12:366–9

    Article  CAS  PubMed  Google Scholar 

  5. Mommsen S, Foldspang A (1994) Body mass index and adult female urinary incontinence. World J Urol 12:319–22

    Article  CAS  PubMed  Google Scholar 

  6. Yarnell JW, Voyle GJ, Sweetnam PM, et al (1982) Factors associated with urinary incontinence in women. J Epidemiol Community Health 36:58–63

    Article  CAS  PubMed  Google Scholar 

  7. Hunskaar S (2008) A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women. Neurourol Urodyn 27:749–57

    Article  PubMed  Google Scholar 

  8. Han MO, Lee NY, Park HS (2006) Abdominal obesity is associated with stress urinary incontinence in Korean women. Int Urogynecol J Pelvic Floor Dysfunct 17:35–9

    Article  PubMed  Google Scholar 

  9. Townsend MK, Curhan GC, Resnick NM, Grodstein F (2008) BMI, waist circumference and incident urinary incontinence in older women. Obesity (Silver Spring) 16:881–6

    Article  Google Scholar 

  10. Subak LL, Whitcomb E, Shen H, et al (2005) Weight loss: a novel and effective treatment for urinary incontinence. J Urol 174:190–5

    Article  PubMed  Google Scholar 

  11. Subak LL, Wing R, West DS, et al (2009) Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med 360:481–90

    Article  CAS  PubMed  Google Scholar 

  12. Auwad W, Steggles P, Bombieri L, et al (2008) Moderate weight loss in obese women with urinary incontinence: a prospective longitudinal study. Int Urogynecol J Pelvic Floor Dysfunct 19:1251–9

    Article  PubMed  Google Scholar 

  13. Cummings JM, Rodning CB (2000) Urinary stress incontinence among obese women: review of pathophysiology therapy. Int Urogynecol J Pelvic Floor Dysfunct 11:41–4

    Article  CAS  PubMed  Google Scholar 

  14. Varner ER (1990) Retropubic long needle suspension procedures for stress urinary incontinence. Am J Obstet Gynecol 163:551–7

    CAS  Google Scholar 

  15. Parnell JP, Marshall VF, Vaughan ED, Jr (1982) Primary management of urinary stress incontinence by the Marshall-Marchetti-Krantz vesicourethropexy. J Urol 127:679–82

    PubMed  Google Scholar 

  16. Gillon G, Engelstein D, Servadio C (1992) Risk factors and their effect on the results of Burch colposuspension for urinary stress incontinence. Isr J Med Sci 28:354–6

    CAS  PubMed  Google Scholar 

  17. Brieger G, Korda A (1992) The effect of obesity on the outcome of successful surgery for genuine stress incontinence. Aust N Z J Obstet Gynecol 32:71–2

    Article  CAS  Google Scholar 

  18. Mukherjee K, Constantine G (2001) Urinary stress incontinence in obese women: tension-free vaginal tape is the answer. BJU Int 88:881–3

    Article  CAS  PubMed  Google Scholar 

  19. Lovatsis D, Gupta C, Dean E, Lee F (2003) Tension-free vaginal tape procedure is an ideal treatment for obese patients. Am J Obstet Gynecol 189:1601–4

    Article  PubMed  Google Scholar 

  20. Rafii A, Darai E, Haab F, et al (2003) Body mass index and outcome of tension-free vaginal tape. Eur Urol 43:288–92

    Article  PubMed  Google Scholar 

  21. Killingsworth LB, Wheeler TL, Burgio KL, et al (2009) One-year outcomes of tension-free vaginal tape (TVT) mid-urethral slings in overweight and obese women. Int Urogynecol J Pelvic Floor Dysfunct 20:1103–8

    Article  PubMed  Google Scholar 

  22. Ku JH, Oh JG, Shin JW, et al (2006) Outcome of midurethral sling procedures in Korean women with stress urinary incontinence according to body mass index. Int J Urol 13:379–84

    Article  PubMed  Google Scholar 

  23. Hellberg D, Holmgren C, Lanner L, Nilsson S (2007) The very obese woman and the very old woman: tension-free vaginal tape for the treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 18:423–9

    Article  PubMed  Google Scholar 

  24. Skriapas K, Poulakis V, Dillenburg W, et al (2006) Tension-free vaginal tape (TVT) in morbidly obese patients with severe urodynamic stress incontinence as last option treatment. Eur Urol 49:544–50

    Article  PubMed  Google Scholar 

  25. Mendoza D, Newman RC, Albala D, et al (1996) Laparoscopic complications in markedly obese urologic patients (a multiinstitutional review). Urology 48:562–7

    Article  CAS  PubMed  Google Scholar 

  26. Singh KB, Huddleston HT, Nandy I (1996) Laparoscopic tubal sterilization in obese women: experience from a teaching institution. South Med J 89:56–9

    CAS  PubMed  Google Scholar 

  27. Chung MK, Chung RP (2002) Comparison of laparoscopic Burch and tension-free vaginal tape in treating stress urinary incontinence in obese patients. JSLS 6:17–21

    PubMed  Google Scholar 

  28. Dindo D, Muller MK, Weber M, Clavien PA (2003) Obesity in general elective surgery. Lancet 361:2032–5

    Article  PubMed  Google Scholar 

  29. Schwandner O, Farke S, Schiedeck TH, Bruch HP (2004) Laparoscopic colorectal surgery in obese and non-obese patients: do differences in body mass indices lead to different outcomes? Surg Endosc 18:1452–6

    Article  CAS  PubMed  Google Scholar 

  30. Bradley CS, Kenton KS, Richter HE, et al (2008) Obesity and outcomes after sacrocolpopexy. Am J Obstet Gynecol 199:690–8

    Article  PubMed  Google Scholar 

  31. Chen CC, Collins SA, Rodgers AK, et al (2007) Perioperative complications in obese women vs. normal-weight women who undergo vaginal surgery. Am J Obstet Gynecol 197:98

    PubMed  Google Scholar 

  32. Rogers RG, Lebkuchner U, Kammerer-Doak DN, et al (2006) Obesity and retropubic surgery for stress incontinence: is there really an increased risk of intraoperative complications? Am J Obstet Gynecol 195:1794–8

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service de gynécologie-obstétrique, Hôtel-Dieu, CHU de Clermont-Ferrand, boulevard Léon-Malfreyt, F-63058, Clermont-Ferrand, France

    B. Fatton

Authors
  1. B. Fatton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B. Fatton.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fatton, B. Chirurgie de l’incontinence urinaire à l’effort chez la femme obèse. Obes 5, 19–24 (2010). https://doi.org/10.1007/s11690-010-0222-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11690-010-0222-4

Mots clés

Keywords

Search

Navigation