Skip to main content

Advertisement

SpringerLink
Log in

The very obese woman and the very old woman: tension-free vaginal tape for the treatment of stress urinary incontinence

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

A mailed questionnaire was sent to 970 consecutive women who underwent a tension-free vaginal tape (TVT) procedure between 1995 and 2001 at the Department of Obstetrics and Gynecology in Falun Hospital. Seven hundred and sixty (78.4%) women responded. The outcome was compared between women older than 75 years (n=113) and younger women, and between women with a body mass index (BMI) above 35 (n=61) and those who had normal weight. Mean follow-up was 5.7 years. Thirty-six elderly women and one of the obese women were deceased at the long-term follow-up. TVT was easy to perform and was a safe procedure for women in all groups. There was a sharp decrease in cure rate of any urinary incontinence problems among women aged 75 years or more (55.7%), as compared to those who were younger (79.7%). The cure rate moderately decreased from BMI groups 19–24 to 30–34. BMI ≥35 seemed to be the best explanatory cutoff level. The overall cure rate in women of normal weight was 81.2%, as compared to 52.1% in the very obese. The cure rate for urinary incontinence with tension-free vaginal tape in women above 75 years of age and in women with a BMI above 35 was acceptable, but lower as compared to the remaining study population.

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

Similar content being viewed by others

References

  1. Cobbs EL, Ralapati AN (1998) Health of older women. Med Clin North Am 82:127–144

    Article  PubMed  CAS  Google Scholar 

  2. Ulmsten U, Petros P (1995) Intravaginal slingplasty (IVS): An ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 29:75–82

    Article  PubMed  CAS  Google Scholar 

  3. Karantanis E, Fynes MM, Stanton SL (2004) The tension-free vaginal tape in older women. BJOG 111:837–841

    Article  PubMed  Google Scholar 

  4. Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Kopkan JP (1999) The spread of the obesity epidemic in the United States, 1991–1998. JAMA 282:1519–1522

    Article  PubMed  CAS  Google Scholar 

  5. Lawrence VJ, Kopelman PG (2004) Medical consequences of obesity. Clin Dermatol 22:296–302

    Article  PubMed  Google Scholar 

  6. 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 

  7. Falconer C, Ekman-Ordeberg G, Ulmsten U, Westergren-Thorsson G, Barchan K, Malmström A (1996) Changes in paraurethral connective tissue at menopause are counteracted by estrogen. Maturitas 24:197–204

    PubMed  CAS  Google Scholar 

  8. Milsom I, Ekelund P, Molander U, Arvidsson L, Areskoug B (1993) The influence of age, parity, oral contraception, hysterectomy and menopause on the prevalence of urinary incontinence in women. J Urol 149:1459–1462

    PubMed  CAS  Google Scholar 

  9. Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff J, Wein AJ (2001) How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int 87:760–766

    Article  PubMed  CAS  Google Scholar 

  10. Lo TS, Huang HJ, Chang CL, Wong SY, Horng SG, Liang CC (2002) Use of intravenous anesthesia for tension-free vaginal tape therapy in elderly women with genuine stress incontinence. Urology 59:349–353

    Article  PubMed  Google Scholar 

  11. Allahdin S, McKinley CA, Mahmoud TA (2004) Tension-free vaginal tape: a procedure for all ages. Acta Obstet Gynecol Scand 83:937–940

    Article  PubMed  Google Scholar 

  12. Bombieri L, Freeman RM, Perkins EP, Williams MP, Shaw SR (2002) Why do women have voiding dysfunction and de novo detrusor instability after colposuspension? BJOG 109:402–412

    Article  Google Scholar 

  13. 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

    PubMed  CAS  Google Scholar 

  14. Subak LL, Johnson C, Whitcomb E, Boban D, Saxton J, Brown JS (2002) Does weight loss improve incontinence in moderately obese women? Int Urogynecol J Pelvic Floor Dysfunct 13:40–43

    Article  PubMed  CAS  Google Scholar 

  15. Cummings JM, Rodning CB (2000) Urinary stress incontinence among obese women: Review of pathophysiology therapy. Int Urogynecol J Pelvic Floor Dysfunct 11:41–44

    Article  PubMed  CAS  Google Scholar 

  16. Lovatsis D, Chander G, Dean E, Lee F (2003) Tension-free vaginal tape procedure is an ideal treatment for obese patients. Am J Obstet Gynecol 189:1601–1605

    Article  PubMed  Google Scholar 

  17. Rafii A, Darai E, Haab F, Samain E, Levardon M, Deval B (2003) Body mass index and outcome of tension-free vaginal tape. Eur Urol 43:288–292

    Article  PubMed  Google Scholar 

  18. Cummings JM, Boullier JA, Parra RO (1998) Surgical correction of stress incontinence in morbidly obese women. J Urol 160:754–755

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Falun Hospital, 791 82, Falun, Sweden

    Dan Hellberg, Corinne Holmgren, Lars Lanner & Staffan Nilsson

  2. Center for Clinical Research, Dalarna, Falun, Sweden

    Dan Hellberg & Staffan Nilsson

  3. Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

    Dan Hellberg & Staffan Nilsson

Authors
  1. Dan Hellberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Corinne Holmgren
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lars Lanner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Staffan Nilsson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dan Hellberg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hellberg, D., Holmgren, C., Lanner, L. et al. The very obese woman and the very old woman: tension-free vaginal tape for the treatment of stress urinary incontinence. Int Urogynecol J 18, 423–429 (2007). https://doi.org/10.1007/s00192-006-0162-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-006-0162-2

Keywords

Search

Navigation