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Transobturator mid-urethral sling versus single incision sling for stress urinary incontinence in overweight and obese patients: a mid-term follow up
Sugarmaa EnkhtaivanBackground: Overweight or obese may have negative impact on the surgical outcomes of sling operations for the treatment of stress urinary incontinence (SUI). The aim of the study was to compare the success rate, quality of life, and complications of transobturator sling (TOS) versus single incision sling (SIS) in these patients.
Methods: This retrospective study analyzed the surgical outcomes of overweight and obese women who underwent midurethral sling surgery. Objective cure rate was defined as no stress urine leakage while comfortably full bladder. Subjective cure rate was determined by patient’s satisfaction. Quality of life was evaluated by valid questionnaires which included the short form of the Urogenital Distress Inventory, the Incontinence Impact Questionnaire, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. Surgical characteristics and postoperative adverse events were also analyzed.
Results: A total of 217 patients were analyzed with a median of follow-up was 26.7 months. For overweight patients, the objective and subjective cure rate was comparable after SIS or TOT (p=0.488 and 0.489, respectively). Similarly, the objective and subjective cure rate were not significant different after different slings in obese patients (p=0.465 and 0.535, respectively). In terms of quality of life and adverse events, there were no significantly different regarding different surgical procedures in obese and overweight patients. Exceptions were TOS needed longer surgery time (p=0.017) and higher postoperative pain (p<0.001).
Conclusions: SIS and TOS had similar surgical results in overweight or obese patients. But TOS operation time is slightly longer and postoperative pain score is higher than SIS.