MP88-07 OBESITY IS ASSOCIATED WITH MALE TRANSOBTURATOR SLING FAILURE

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Male Incontinence: Therapy1 Apr 2015MP88-07 OBESITY IS ASSOCIATED WITH MALE TRANSOBTURATOR SLING FAILURE Divya Ajay, John Selph, Michael Belsante, Aaron Lentz, Ngoc-Bich Le, George Webster, and Andrew Peterson Divya AjayDivya Ajay More articles by this author , John SelphJohn Selph More articles by this author , Michael BelsanteMichael Belsante More articles by this author , Aaron LentzAaron Lentz More articles by this author , Ngoc-Bich LeNgoc-Bich Le More articles by this author , George WebsterGeorge Webster More articles by this author , and Andrew PetersonAndrew Peterson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1840AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While the reported Transobturator Sling (TOS) success rates for post-prostatectomy stress urinary incontinence (PPSUI) ranges from 41-76%, little is known about pre-operative risk factors that affect TOS outcomes. Our objective is to identify factors that contribute to TOS outcomes to aid in patient counselling and clinical decision making. METHODS Under an IRB-approved protocol, we reviewed all patients undergoing a TOS placement at our institution from 2006 to 2012. Demographic data, comorbidities and continence rates were evaluated. Post-operative sling success was defined as the use of 0 or 1 security pads over 24 hours, negative stress test on exam or pad weight less than 8 g per 24 hours. BMI was calculated by height and weight as recorded on the day of surgery or within 6 months prior to TOS surgery. Obesity is defined as BMI greater or equal 30 kg/m2 per WHO guidelines. Cox regression model and Kaplan-Meier survival analysis were performed. RESULTS 290 patients met inclusion criteria. Average age at surgery was 66.3 (± 7.4) years and 84% were Caucasian. Median time to follow-up was 5 months (IQR 14). Preoperative risk factors including age, race, BMI, diabetes, hypertension, immunosuppression, smoking status and prior pelvic were evaluated. The hazard ratio for failure with a BMI of greater than or equal to 30 compared with a BMI of less than 30 kg/m2 was 1.5 (p=0.04). After adjusting for age, race, diabetes, hypertension, immunosuppression, smoking status and prior pelvic radiation, the hazard ratio was 1.06 (p=0.039). In comparison, the hazard ratio for a known poor risk factor, prior EBRT, was 1.5 (p=0.031). None of the other variables significantly affected TOS outcomes. Figure 1 illustrates a statistically significant difference in estimated TOS failure over time for obese versus not obese patients. CONCLUSIONS In our cohort of patients with PPSUI, those with a BMI of greater than or equal to 30 kg/m2 were 1.5 times as likely to experience TOS failure versus those with a BMI of 30 kg/m2 or less. This is important for the clinicians when counseling the obese patient for surgical management of PPSUI. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1094-e1095 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Divya Ajay More articles by this author John Selph More articles by this author Michael Belsante More articles by this author Aaron Lentz More articles by this author Ngoc-Bich Le More articles by this author George Webster More articles by this author Andrew Peterson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...