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Effect of BMI on clinical outcomes following minimally invasive sacrocolpopexy

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Abstract

Our objective was to compare success and complication rates following minimally invasive sacrocolpopexy (SCP) based on body mass index (BMI). This is a retrospective cohort study of women who underwent laparoscopic or robotic SCP at one academic center from 2006 to 2016. Women were included if they had a postoperative pelvic organ prolapse quantification (POPQ) exam and subjective success documented. For our primary outcome, we compared composite success (POPQ stage ≤ I and report of no bulge symptoms) amongst three groups: normal weight (BMI ≤ 25), overweight (BMI 25–30) and obese (BMI ≥ 30) women. Secondary outcomes included intraoperative complications, 6 week postoperative complications, and sacrocolpopexy mesh exposure. Of the 431 women who met inclusion criteria, 140 (32%) had normal BMI (23 kg/m2; IQR 22, 24), 177 (41%) were overweight (27 kg/m2; IQR 26, 28), and 114 (26%) were obese (32 kg/m2; IQR 31, 36). Mean age was 60 ± 11 years, and most were Caucasian, with no differences in demographics or Charlson Comorbidity Index (CCI). Median length of follow-up was 49 weeks (IQR 9, 104), with similar follow-up for all groups. For our primary outcome, composite success was 72% overall, with no significant differences in composite success rates between groups. For secondary outcomes, there were no differences in the rates of perioperative complications but obese women had a 2.8 increased risk of mesh exposure (p = 0.02). Obesity was not associated with differences in the success or peri-operative complication rates for SCP in our population, but was associated with mesh exposure.

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Funding

There was no funding for this study.

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Authors and Affiliations

  1. Division of Urogynecology and Reconstructive Pelvic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, 3032 Old Clinic Building, CB#7570, Chapel Hill, NC, 27599-7570, USA

    Radhika Patnam, Katherine Husk, Abhishek Sripad, Kathryn Barletta, Alexis Dieter & Elizabeth J. Geller

  2. Division of Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, CB#7570, Chapel Hill, NC, 27599-7570, USA

    Elizabeth J. Geller

Authors
  1. Radhika Patnam
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  2. Katherine Husk
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  3. Abhishek Sripad
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  4. Kathryn Barletta
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  5. Alexis Dieter
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  6. Elizabeth J. Geller
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Correspondence to Elizabeth J. Geller.

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Conflict of interest

Radhika Patnam, Katherine Husk, Abhishek Sripad, Kathryn Barletta, Alexis Dieter and Elizabeth Geller declare they have no conflicts of interest.

Informed consent

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of The University of North Carolina approved this study, IRB# 18-2500. This article does not contain any studies with human or animal subjects performed by any of the authors.

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Patnam, R., Husk, K., Sripad, A. et al. Effect of BMI on clinical outcomes following minimally invasive sacrocolpopexy. J Robotic Surg 15, 63–68 (2021). https://doi.org/10.1007/s11701-020-01079-2

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  • DOI: https://doi.org/10.1007/s11701-020-01079-2

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