ArticlePloS one2014
The long-term influence of body mass index on the success rate of mid-urethral sling surgery among women with stress urinary incontinence or stress-predominant mixed incontinence: comparisons between retropubic and transobturator approaches.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- The impact of overweight in the efficiency and complications of midurethral sling in patients with stress urinary incontinence: a systematic review and meta-analysis.International urology and nephrology · 2018Pooled it
- Mid-term results of ReMEEX sling system in female stress urinary incontinence with various indications and feasibility of readjustment.Investigative and clinical urology · 2024Article
- The Role of a Spinning Top Urethra in the Development of Pyosalpinx in a Precoital Female.Cureus · 2022Article
- A comprehensive look at risk factors for mid-urethral sling revision surgery.International urogynecology journal · 2020Article
- Obesity and Stress Urinary Incontinence: Impact on Pathophysiology and Treatment.Current urology reports · 2018Review
- Five years after midurethral sling surgery for stress incontinence: obesity continues to have an impact on outcomes.International urogynecology journal · 2017Article
- Obesity and Pelvic Floor Disorders: A Review of the Literature.Medical science monitor : international medical journal of experimental and clinical research · 2016Review
- Incontinence surgery in obese women: comparative analysis of short- and long-term outcomes with a transobturator sling.International urogynecology journal · 2016Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMid-urethral sling (MUS) surgery for the treatment of urinary incontinence has been widespread since the introduction of tension-free vaginal tape in the mid-1990s. The majority of studies with short-term follow-up <2 years found no differences in the surgical outcomes according to body mass index (BMI). However, considering the chronic influence of obesity on pelvic floor musculature, it is cautiously speculated that higher BMI could increase stress on pelvic floor and sub-urethral tape, possibly decreasing the long-term success rate in the obese population. We aimed to compare the long-term effects of BMI on the outcomes of MUS between women with retropubic and transobturator approaches.
methodsWe performed a retrospective analysis on 243 consecutive women who received MUS and were followed up for ≥36 months. The influence of BMI on the success rates was separately estimated and the factors for treatment failure were examined using logistic regression in either approach.
resultsThe mean follow-up was 58.4 months, and 30.5% were normal weight, 51.0% overweight, and 18.5% obese. Patients received either the retropubic (30.5%) or transobturator (69.5%) approach. The success rates (%) under the transobturator approach differed according to the BMI groups (94.3, 88.6, and 78.6, respectively; P = 0.037) while those under the retropubic approach were not different according to the BMI groups. However, in multivariate models, only the presence of preoperative mixed urinary incontinence (MUI) was proven to be the risk factor for treatment failure in the transobturator approach (OR 6.39, P = 0.003). The percent of subjects with MUI was higher in obese women than in non-obese women with the transobturator approach.
conclusionsBMI was not independently associated with failures in either approach. Higher success rates in women with lower BMI in the transobturator approach were attributed to the lower percent of preoperative MUI in those with lower BMI.
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