Transactions from the Thirty-Second Annual Scientific Meeting of the Society of Gynecologic SurgeonsObesity and retropubic surgery for stress incontinence: Is there really an increased risk of intraoperative complications?
Section snippets
Material and methods
Women participating in a multicenter, randomized trial to evaluate the use of prophylactic antibiotics in women who had suprapubic catheters placed after surgery for SUI were eligible to participate. All 6 sites obtained institutional review board approval. Two hundred fifty of the 449 women (56%) recruited for the main study underwent retropubic urethropexy as well as other reparative procedures, gave BMI data, and were included in the present analysis. Results of the main study have been
Results
Two hundred fifty women underwent retropubic urethropexy and gave BMI data, of whom 79 (32%) were obese, 92 (36%) overweight, and 79 (32%) normal weight. No differences in demographic or outcome variables between overweight and normal-weight women were observed (all P = NS); therefore, all comparisons are between obese and nonobese women. Retropubic procedures performed included 168 open Burch (67%), 12 laparoscopic Burch (5%), 44 Marshall-Marchetti-Krantz (18%), and 25 Ball-Burch procedures
Comment
Results of the National Health and Nutrition Examination Survey 1999 to 2000 indicate that an estimated 64% of U.S. adults are either overweight or obese.5 Obese women are at increased risk for SUI with each 5-unit increase in BMI, resulting in a 60% to 100% increase in the risk of daily incontinence.6, 7 Weight loss as small as 5% to 10% of body weight results in significant reduction of incontinence symptoms and should be part of the first line therapy for SUI for obese women.6, 7 Weight
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Cited by (34)
Pelvic floor dysfunction and obesity
2023, Best Practice and Research: Clinical Obstetrics and GynaecologyImpact of obesity on operative complications and outcome after sacrocolpopexy: A systematic review and meta-analysis
2021, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :Some studies have suggested that obesity may influence the complication rate and effectiveness of sacrocolpopexy, but this remains a matter of debate. A retrospective study of women with pelvic organ prolapse undergoing sacrocolpopexy reported that obesity may increase the risk of both perioperative and postoperative complications [7], but another study found no significant difference in complications between obese women and those of healthy weight [8]. Regarding surgical effectiveness, the general view is that gynaecologic surgery is associated with increased morbidity in obese patients [9].
Maternal obesity and major intraoperative complications during cesarean delivery
2017, American Journal of Obstetrics and GynecologyObesity and pelvic floor dysfunction
2015, Best Practice and Research: Clinical Obstetrics and GynaecologyCitation Excerpt :A subjective improvement was noted among all the BMI groups, but a lesser objective efficacy was noted with an increasing BMI [18,33]. It has also been observed in a case–control study that, compared with the non-obese population, the operating time was more prolonged with a slightly higher estimated blood loss in obese patients undergoing tape procedures for urinary incontinence [19,31]. It is useful to counsel the patients prior to the procedure with the available evidence and local data on outcomes after incontinence surgery before making an informed decision about surgical treatment among the other options available.
Obesity and female stress urinary incontinence
2013, UrologyCitation Excerpt :Although retropubic midurethral sling surgery on the obese patient is perceived to be more difficult by surgeons, there is no evidence that complications, such as blood loss and visceral injuries, are higher in obese patients. Even when a significantly longer operating time was reported, this was not associated with a higher complication rate.33 Because the obese female population has a high prevalence of stress urinary incontinence, these patients often present for surgical evaluation.
Supported in part by Department of Health and Human Services/National Institutes of Health/National Center Research Resources/General Clinical Research Center Grant 5M01 RR00997.
Presented at the 32nd Annual Meeting of the Society of Gynecologic Surgeons, April 3-5, 2006, Tucson, AZ.
Reprints not available from the authors.