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Efficacy and perioperative safety of synthetic mid-urethral slings in obese women with stress urinary incontinence

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Abstract

Introduction and hypothesis

Obesity is associated with an increased prevalence of female stress urinary incontinence (SUI). Mid-urethral polypropylene sling is considered the surgical gold standard for treatment of SUI. We reviewed the current literature on efficacy at 1 year (or more) and perioperative safety of synthetic mid-urethral sling procedures for SUI in obese women.

Methods

A systematic search of PubMed, Embase and the Cochrane databases was performed using the MeSH terms “Stress urinary incontinence”, “Overweight”, “Obesity” and “Surgery”. We included 13 full-text papers published from January 1995 to May 2014. We defined two groups of women: non-obese (BMI below 30 kg/m2) and obese (BMI above 30 kg/m2). Data regarding subjective and objective cure and selected perioperative complications were pooled and compared.

Results

The pooled data from the 13 studies showed that 76.4 % and 74.7 % of non-obese and obese women, respectively, were subjectively cured (p = 0.70), and 83.3 % and 79.2 %, respectively, were objectively cured (p = 0.56). Bladder perforation was more frequently reported in non-obese women (p < 0.01). We did not detect a significant difference in postoperative urine retention or sling excision between the two groups (p = 0.36 and p = 0.17, respectively).

Conclusions

Cure rates were found to be comparable in obese and non-obese women. Perioperative complications were not reported to occur more often in obese women. The outcomes of sling procedures for SUI appear to be comparable in obese and non-obese women, and counselling of obese women regarding outcomes and perioperative complications can be similar.

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Conflicts of interest

Dr. Guldberg reports grants from Astellas, outside the submitted work. Dr. Lose reports grants from Advanced Technology Foundation, outside the submitted work.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Herlev University Hospital, Herlev, Denmark

    V. Weltz & G. Lose

  2. Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark

    R. Guldberg

  3. Department of Obstetrics and Gynecology, Holbæk Hospital, Holbæk, Denmark

    V. Weltz

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  1. V. Weltz
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  2. R. Guldberg
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  3. G. Lose
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Correspondence to V. Weltz.

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Weltz, V., Guldberg, R. & Lose, G. Efficacy and perioperative safety of synthetic mid-urethral slings in obese women with stress urinary incontinence. Int Urogynecol J 26, 641–648 (2015). https://doi.org/10.1007/s00192-014-2567-7

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  • DOI: https://doi.org/10.1007/s00192-014-2567-7

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