Abstract
Introduction and hypothesis
A few series comparing the clinical efficacy of midurethral slings in obese and postmenopausal patients are available. The aim of the study was to assess clinical efficacy of suburethral tape operations for the surgical treatment of female stress urinary incontinence (SUI) stratified by obesity, menopause and ageing.
Methods
Five hundred thirty-seven patients underwent either retropubic or transobturator sling procedure. Patients were randomly allocated into two study groups in a ratio of 1:1. After 18 months, 398 women were available for a follow-up efficacy evaluation.
Results
The clinical effectiveness of surgical SUI treatment did not depend on patients' body mass index (BMI) and type of midurethral sling, but menopausal status and ageing significantly influenced the outcome of the surgery.
Conclusions
We found that BMI does not influence the clinical effectiveness of SUI treatment, whereas both menopause and ageing had a detrimental influence on the final outcome of the surgery.
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References
Parazzini F, Colli E, Origgi G, Surace M, Bianchi M, Benzi G et al (2000) Risk factors for urinary incontinence in women. Eur Urol 37:637–643
Hunskaar S, Burgio K, Clark A, Lapitan MC, Nelson R, Sillen U et al (2005) Epidemiology of urinary (UI) and faecal (FI) incontinence and pelvic organ prolapse (POP). In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence, Vol. I, Basics & Evaluation. Health Publication Ltd, Plymouth, pp 255–312
Office of Disease Prevention and Health Promotion (2001) The US Surgeon General's call to action to prevent and decrease overweight and obesity. Office of Disease Prevention and Health Promotion, Center for Disease Control and Prevention, National Institutes of Health, Office of the Surgeon General, Rockville. Available at: http://www.surgeongeneral.gov/topics/obesity/calltoaction/CalltoAction.pdf
Bortolotti A, Bernardini B, Colli E, Di Benedetto P, Giocoli Nacci G, Landoni M et al (2000) Prevalence and risk factors for urinary incontinence in Italy. Eur Urol 37:30–35
Miller YD, Brown WJ, Russell A, Chiarelli P (2003) Urinary incontinence across the lifespan. Neurourol Urodyn 22:550–557
Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S (2003) Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG 10:247–254
Deitel M, Stone E, Kassam HA, Wilk EJ, Sutherland DJ (1988) Gynecologic obstetric changes after loss of massive excess weight following bariatric surgery. J Am Coll Nutr 7:147–153
Burgio KL, Richter HE, Clements RH, Redden DT, Goode PS (2007) Changes in urinary and fecal incontinence symptoms with weight loss surgery in morbidly obese women. Obstet Gynecol 110:1034–1040
Nygaard IE (1997) Does prolonged high-impact activity contribute to later urinary incontinence? A retrospective cohort study of female Olympians. Obstet Gynecol 90:718–722
Cardozo LD, Rekers H, Tapp A (2003) Oestriol in the treatment of postmenopausal urgency: a multicenter study. Maturitas 45:47–53
Robinson D, Cardozo LD (2003) The role of estrogens in female lower urinary tract dysfunction. Urology 62:45–51
Tincello DG, Taylor AH, Spurling SM, Bell SC (2009) Receptor isoforms that mediate estrogen and progestagen action in the female lower urinary tract. J Urol 181:1474–1482
Dennerstein L, Dudley EC, Hopper JL, Guthrie JR, Burger HG (2000) A prospective population-based study of menopausal symptoms. Obstet Gynecol 96:351–358
Townsend MK, Curhan GC, Resnick NM, Grodstein F (2009) Postmenopausal hormone therapy and incident urinary incontinence in middle-aged women. Am J Obstet Gynecol 200:86.e1–86.e5
Rechberger T, Futyma K, Jankiewicz K, Adamiak A, Skorupski P (2009) The clinical effectiveness of retropubic (IVS-02) and transobturator (IVS-04) midurethral slings: randomized trial. Eur Urol 56:24–30
Olsen AL, Smith VJ, Bergstrom JO, Culling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapsed and urinary incontinence. Obstet Gynecol 89:501–506
Gillon G, Engelstein D, Servadio C (1992) Risk factors and their effect on the results of Burch colposuspension for urinary stress incontinence. Israel J Med Sci 28:354–356
Cummings JM, Boullier JA, Parra RO (1998) Surgical correction of incontinence in the morbidly obese woman. J Urol 160:754–755
Paick JS, Cho MC, Oh SJ, Kim SW, Ku JH J (2007) Factors influencing the outcome of mid urethral sling procedures for female urinary incontinence. Urol 178:985–989
Hellberg D, Holmgren C, Lanner L, Nilsson S (2007) The very obese woman and the very old woman: tension-free vaginal tape for the treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 18:423–429
Rafii A, Dara 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
Skriapas K, Poulakis V, Dillenburg W, de Vries R, Witzsch U, Melekos M et al (2006) Tension-free vaginal tape (TVT) in morbidly obese patients with severe urodynamic stress incontinence as last option treatment. Eur Urol 49:544–550
Lovatsis D, Gupta C, Dean E, Lee F (2003) Tension-free vaginal tape procedure is an ideal treatment for obese patients. Am J Obstet Gynecol 189:1601–1604
Rizk DE, Fahim MA (2008) Ageing of the female pelvic floor: towards treatment a la carte of the “geripause”. Int Urogynecol J Pelvic Floor Dysfunct 19:455–458
Goh JT (2002) Biomechanical properties of prolapsed vaginal tissue in pre- and postmenopausal women. Int Urogynecol J Pelvic Floor Dysfunct 13:76–79
Zoubina EV, Mize AL, Alper RH, Smith PG (2001) Acute and chronic estrogen supplementation decreases uterine sympathetic innervation in ovariectomized adult virgin rats. Histol Histopathol 16:989–996
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This paper was supported by KBN grant no: N407 309433.
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Rechberger, T., Futyma, K., Jankiewicz, K. et al. 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 (2010). https://doi.org/10.1007/s00192-010-1116-2
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DOI: https://doi.org/10.1007/s00192-010-1116-2