Does patient weight influence the outcome of the tension-free vaginal tape procedure? A long-term follow-up study
Tsivian, Alexander; Neuman, Menahem; Kessler, Oded; Mogutin,
Baruch; Korczak, Doron; Levin, Samuel; Sidi, A.
Urinary stress incontinence (USI) is
more common in obese women.
The influence of obesity on surgical
treatment for USI is controversial. We sought to determine whether
obesity affects the outcome of the tension-free vaginal tape (TVT)
procedure. The retrospective data of 81 women that underwent the TVT
procedure between 04/1998 and 12/2000 were studied. The study cohort
women (aged 37-87 years) were subdivided into three groups according
to body mass index (BMI): normal (BMI = <25)—group 1, overweight
(BMI = 25-29)—group 2, and obese (BMI = >30)—group 3.
All women underwent preoperative
examinations, including detailed medical history and physical
examination with stress tests and urodynamic studies. Follow-up
included post-procedure check-up meetings at 1, 3, 6, and 12 months
and once yearly thereafter (minimal follow-up = 52 months). Intra-
and postoperative complications and success rates were compared
among the three groups. Twenty-six (32.1%) women had normal BMI, 21
(25.9%) were overweight, and 34 (42%) were obese. Six intraoperative
complications were recorded, including 5 bladder injuries and 1
urethral injury, none of which required surgical re-intervention.
Eight reported postoperative
complications included 1 bladder erosion, 3 urethral obstructions, 4
vaginal erosions (1 patient suffered from concomitant urethral
obstruction and vaginal erosion). Five patients diagnosed with
postoperative surgical complications underwent corrective surgery.
There were no significant inter-group differences among the
The success rates were 84.6%, 81%, and
79.4% in groups 1, 2, and 3 respectively. Increased BMI may have a
slight negative impact on TVT results, but the long-term success
rate of 79.4% in obese women and the lack of any direct correlation
between BMI and complications sanction their undergoing TVT.
Gynecological Surgery, Volume 3, Number 3, September 2006 , pp.