7 Effectiveness of transobturator tape procedure in obese and severe obese women: 3-year follow-up

Abstract

Objective To assess the efficacy and safety of transobturator tape (TOT) for the treatment of stress urinary incontinence in severely obese and obese women. Methods We retrospectively reviewed the women who underwent a TOT procedure at 2 institutions between March 2005 and March 2013. The patients were divided into 3 groups according to the World Health Organization body mass index (BMI) values: normal weight group (BMI <25 kg/m2; group 1), obese group (BMI = 30-34 kg/m2; group 2), and severely obese group (BMI ≥35 kg/m2; group 3). Overweight women (BMI = 25-29 kg/m2) were omitted. Patients filled in the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) preoperatively and at the postoperative follow-up visits. The severity of urinary incontinence was classified by ICIQ-SF: slight (1-5), moderate (6-12), severe (13-18), and very severe (19-21). Patient satisfaction was assessed using a visual analog scale. Subjective improvement was defined as an ICIQ-SF score ≤12 and satisfaction with surgery (visual analog scale score ≥80). Results A total 470 women met the requirements for inclusion. There were 153 women in group 1, 72 women in group 2, and 32 women in group 3. Mean follow-up period was at least 12 months in all the groups. The difference between the groups according to mean operative time was significant (P <.001). The objective cure, subjective success (cured and improved), patient satisfaction rates, and complications were similar between the groups. Conclusion Obesity and severe obesity do not seem to be risk factors for the failure of TOT procedure. However, postoperative urgency urinary incontinence rate was higher in severely obese women, and more women showed improvement instead of cure among severely obese women.