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Clinical impact of body mass index on the outcome of the SPARC-sling system for the treatment of female stress urinary incontinence

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Abstract

Purpose

Of this observational study was to evaluate the clinical outcome of the suprapubic arc (SPARC)-sling system in women with stress urinary incontinence according to body mass index (BMI).

Materials and methods

A total of 151 women underwent SPARC between June 2001 and March 2009 at a single tertiary academic center. A complete urodynamic investigation was performed preoperatively. A minimum follow-up of 12 months was required, which left data of 93 individuals for analyses. Participants were divided into the following: A, non-obese (BMI 18.5 to <25 kg/m2), B, overweight (BMI 25 to <30 kg/m2), and C, obese (BMI 30–35 kg/m2). Objective and subjective cure rates, as well as overall success rate and self-perceived severity of bother, were measured. Moreover, participants were asked about their satisfaction after surgery.

Results

Median follow-up was 7.6 years. Mean number of pads/day, pad test, and self-perceived severity of bother were significantly reduced overall, as well as in each BMI category (P < 0.001). In multivariable analyses, BMI was not an independent predictor of objective cure rate, coded either as continuous (P = 0.108) or as categorical variable (P for trend 0.301). Similarly, BMI was not an independent predictor of subjective cure rate, both coded as continuous (P = 0.475) and as categorical variable (P for trend 0.690). Overall, 92% (A), 85% (B), and 80% (C) of participants were satisfied with the surgical outcome at follow-up, respectively.

Conclusions

BMI failed to achieve independent predictor status regarding objective and subjective cure rate at follow-up. A high BMI is not a contraindication to SPARC, more studies are recommended to confirm these findings.

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Abbreviations

WHO:

World Health Organization

SUI:

Stress urinary incontinence

TVT:

Tension-free vaginal tape

SPARC:

Suprapubic arc-sling system

BMI:

Body mass index

VAS:

Visual analogue scale

IQR:

Interquartile ranges

MUCP:

Maximum urethral closure pressure

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Conflict of interest

None of the contributing authors have any conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript.

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Authors and Affiliations

  1. Department of Urology, Medical University of Graz (MUG), Auenbruggerplatz 7, 8036, Graz, Austria

    Badereddinn Mohamad Al-Ali, Georg C. Hutterer, Erika Puchwein, Karl Pummer & Günter Primus

  2. Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Padua, Italy

    Giacomo Novara

Authors
  1. Badereddinn Mohamad Al-Ali
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  2. Georg C. Hutterer
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  3. Erika Puchwein
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  4. Karl Pummer
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  5. Giacomo Novara
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  6. Günter Primus
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Correspondence to Badereddinn Mohamad Al-Ali.

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Mohamad Al-Ali, B., Hutterer, G.C., Puchwein, E. et al. Clinical impact of body mass index on the outcome of the SPARC-sling system for the treatment of female stress urinary incontinence. World J Urol 31, 875–880 (2013). https://doi.org/10.1007/s00345-011-0805-x

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  • DOI: https://doi.org/10.1007/s00345-011-0805-x

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