Skip to main content

Advertisement

SpringerLink
Log in

The impact of overweight in the efficiency and complications of midurethral sling in patients with stress urinary incontinence: a systematic review and meta-analysis

  • Urology - Review
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Aims

To compare the efficiency and complications of normal weight and overweight women with stress urinary incontinence (SUI) after surgery.

Methods

We searched the PubMed, Embase, and Cochrane Library Databases to identify all compared results, including those involving the terms normal weight, overweight, body mass index (BMI), and SUI. After treatment with surgery, the efficiency (subjective cure rate, objective cure rate, UDI-6, and IIQ-7) and complications were compared between the normal weight and overweight groups.

Results

The study inclusion criteria were met by 20 studies involving 3829 patients. The data synthesized from these studies indicated that the subjective and objective cure rates in the normal weight group were significantly more effective than those in the overweight group (RR 1.07; 95% CI 1.04–1.10; P < 0.00001; RR 1.24; 95% CI 1.18–1.30; P < 0.00001), while the IIQ-7 and UDI-6 were no different between the two groups (MD 0.07; 95% CI − 1.44 to 1.58; P = 0.93; MD 0.18; 95% CI − 1.24 to 1.60; P = 0.81). For the data of complications, only the urgency was more in the overweight group (RR 0.68, 95% CI 0.55–0.84, P = 0.0003).

Conclusions

The objective success rate and subjective success rate of the surgery were higher in normal weight patients than those in overweight patients. Also, the side effects between the two groups were not significantly different.

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

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ogden CL, Carroll MD, Curtin LR et al (2006) Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 295(13):1549–1555

    Article  PubMed  CAS  Google Scholar 

  2. http://www.who.int/mediacentre/factsheets/fs311/en/index

  3. Dee A, Kearns K, O’neill C et al (2014) The direct and indirect costs of both overweight and obesity: a systematic review. BMC Res Notes 7:242

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kelleher CJ, Cardozo LD, Toozs-Hobson PM (1995) Quality of life and urinary incontinence. Curr Opin Obstet Gynecol 7:404

    Article  PubMed  CAS  Google Scholar 

  5. Yonguc T, Tansu D, Halil IB et al (2015) Effectiveness of transobturator tape procedure in obese and severely obese women: 3-year follow-up. Urology 86(2):244–248

    Article  PubMed  Google Scholar 

  6. Mohamad A-AB, Hutterer GC, Erika P et al (2013) 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

    Article  Google Scholar 

  7. Brennand EA, Tang S, Williamson T et al (2015) Twelve-month outcomes following midurethral sling procedures for stress incontinence: impact of obesity. BJOG 122:1705–1712

    Article  PubMed  CAS  Google Scholar 

  8. Brennand EA, Tang S, Colin B et al (2016) Five years after midurethral sling surgery for stress incontinence: obesity continues to have an impact on outcomes. Int Urogynecol J 28(4):621–628

    Article  PubMed  Google Scholar 

  9. Esin S, Salman MC, Ozyuncu O et al (2011) Surgical outcome of transobturator tape procedure in obese and non-obese women. J Obstet Gynaecol 31:645–649

    Article  PubMed  CAS  Google Scholar 

  10. Frohme C, Friederike L, Zoltan V et al (2014) TOT Approach in stress urinary incontinence (SUI)—outcome in obese female. BMC Urol 14:20–25

    Article  PubMed  PubMed Central  Google Scholar 

  11. Sung HI, Yu JH, Chung JY et al (2011) One-year outcomes of mid-urethral sling procedures for stress urinary incontinence according to body mass index. Korean J Urol 53:171–177

    Google Scholar 

  12. Jin JS, Keun L, Han S, Lee J, et al (2014) 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. PLoS ONE 9(11):e113517

    Article  CAS  Google Scholar 

  13. Karaman U, Campbell KJ, Frilot CF et al (2016) The impact of obesity on outcomes and complications after top-down retropubic midurethral sling. Neurourol Urodynam 9999:1–6

    Google Scholar 

  14. 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 20:1103–1108

    Article  Google Scholar 

  15. Kuntay KM, Sabri C, Demet K et al (2016) A comperative study for short-term surgical outcomes of midurethral sling procedures in obese and non-obese women with stress urinary incontinence. J Obstet Gynaecol 36(8):1080–1085

    Article  Google Scholar 

  16. Liu P-E, Chin-Hui S, Hui-Hsuan L et al (2011) Outcome of tension-free obturator tape procedures in obese and overweight women. Int Urogynecol J 22:259–263

    Article  PubMed  Google Scholar 

  17. Mckenna JB, Parkin K, Cheng Y et al (2016) Objective efficacy of the tension-free vaginal tape in obese/morbidly obese women versus non-obese women, at median five year follow up. ANZJOG 56(6):628–632

    PubMed  Google Scholar 

  18. Meschia M, Rossi G, Bertini S et al (2013) Single incision mid-urethral slings: impact of obesity on outcomes. EJOGRB 170:571–574

    Google Scholar 

  19. Moore RD, De Ridder D, Kennelly MJ (2012) Two-year evaluation of the MiniArc in obese versus non-obese patients for treatment of stress urinary incontinence. Int J Urol 20(4):434–440

    Article  PubMed  Google Scholar 

  20. Mukherjee K, Constantine G (2001) Urinary stress incontinence in obese women: tension free vaginal tape is the answer. BJU Int 88:881–883

    Article  PubMed  CAS  Google Scholar 

  21. Rafii A, Daraï E, Haab F et al (2003) Body mass index and outcome of tension-free vaginal tape. Eur Urol 43:288–292

    Article  PubMed  Google Scholar 

  22. Rechberger T, Konrad F, Katarzyna J et al (2010) Body mass index does not influence the outcome of anti-incontinence surgery among women whereas menopausal status and ageing do: a randomised trial. Int Urogynecol J 21:801–806

    Article  PubMed  Google Scholar 

  23. Tchey DU, Kim WT, Kim YJ et al (2010) Influence of obesity on short-term surgical outcome of the transobturator tape procedure in patients with stress urinary incontinence. INJ 14:13–19

    PubMed  Google Scholar 

  24. Tsivian A, Menahem N, Oded K et al (2006) Does patient weight influence the outcome of the tension-free vaginal tape procedure. Gynecol Surg 3:195–198

    Article  Google Scholar 

  25. Higgins J, Green S (2012) Cochrane handbook for systematic reviews of interventions Version 5.1.4(updated March 2011) The cochrane collaboration 2011. Available at http://training.cochrane.org/handbook. Accessed 27 Feb 2012

  26. Noblett KL, Jensen JK, Ostergard DR (1997) The relationship of body mass index to intra-abdominal pressure as measured by multichannel cystometry. Int Urogynecol J Pelvic Floor Dysfunct 8:323–326

    Article  PubMed  CAS  Google Scholar 

  27. Padmanabhan P, Dmochowski R, Ginecol M (2014) Urinary incontinence in women: a comprehensive review of the pathophysiology, diagnosis and treatment. Minerva Ginecol 66: 469–478

    PubMed  CAS  Google Scholar 

Download references

Funding

This study was supported by the National Natural Science Foundation of China (Grant No. 81370855, 81300627, and 81200551); the Prostate Cancer Foundation Young Investigator Award 2013 and the Foundation of Science &Technology Department of Sichuan Province (Grant No. 2015SZ0230, 2013SZ0006, and 2013SZ0093); and the Scientific Research Project of Health Department of Sichuan Province (No. 120203).

Author information

Author notes

  1. Yi Sun and Guo-Lin Lei contributed equally to this work and should share the co-first authors.

Authors and Affiliations

  1. Department of Urology, West China Hospital of Sichuan University, No.37 Guoxue Xiang, Chengdu, 610041, Sichuan, China

    Yi Sun, Cai Tang, Lu Yang, Hong Shen & Qiang Wei

  2. Department of Urology, People’s Hospital of Jianyang City, Yiyuan Road, Jianyang, Sichuan, China

    Guo-Lin Lei

Authors
  1. Yi Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guo-Lin Lei
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cai Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lu Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hong Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Qiang Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qiang Wei.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sun, Y., Lei, GL., Tang, C. et al. The impact of overweight in the efficiency and complications of midurethral sling in patients with stress urinary incontinence: a systematic review and meta-analysis. Int Urol Nephrol 50, 1597–1606 (2018). https://doi.org/10.1007/s11255-018-1928-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-018-1928-4

Keywords

Search

Navigation