PD39-12 ARTIFICIAL URINARY SPHINCTERS; EFFECT OF OBESITY ON SURGICAL OUTCOMES

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy II1 Apr 2018PD39-12 ARTIFICIAL URINARY SPHINCTERS; EFFECT OF OBESITY ON SURGICAL OUTCOMES Valary Raup, Pamela Lu, Malte Vetterlein, Bjoern Loeppenberg, Christian Meyer, Quoc-Dien Trinh, and Jairam Eswara Valary RaupValary Raup More articles by this author , Pamela LuPamela Lu More articles by this author , Malte VetterleinMalte Vetterlein More articles by this author , Bjoern LoeppenbergBjoern Loeppenberg More articles by this author , Christian MeyerChristian Meyer More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author , and Jairam EswaraJairam Eswara More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1924AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES As the waist size of the average American continues to grow, it becomes increasingly important to acknowledge the ways in which obesity affects surgical outcomes, particularly regarding elective surgery. Here, we examine how an increasing body mass index (BMI) effects the peri-operative outcomes of artificial urinary sphincter (AUS) placement. METHODS The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Participant User Files (2007-2012) was queried using Current Procedural Terminology (CPT) codes for AUS placement (35445). Prolonged length of stay (pLOS), prolonged operative time (pOT), 30-day complications, and need for reoperation were analyzed with obesity defined as BMI>30, as well as with BMI organized into standard quartiles. pOT and pLOS were defined as an operating time and a hospital length-of-stay greater than the 75th percentile, respectively (pOT=114 minutes and pLOS=1 day). RESULTS 611 male patients who underwent an initial AUS insertion were identified, with a median age at time of surgery of 71 years (18-89). BMI quartiles were as follows: <18.5 (4 patients, 0.6%), 18.5-24.9 (89 patients, 14.6%), 25-29.9 (270 patients, 44.2%), >30 (249 patients, 40.8%). BMI was not associated with pOT (p=0.668; quartiles p=0.666) or pLOS (p=0.487; quartiles p=0.582). BMI was also not associated with need for reoperation (19 patients, 3.1%; p=0.537; quartiles p=0.320) or other post-operative complications (20 patients, 3.3%; p=0.318, quartiles p=0.516). However, when broken into subcategory, obesity (BMI>30) was associated with increased wound dehiscence (p=0.019), urinary tract infection (UTI) (p=0.018), and deep vein thromboses (0.019). A detailed analysis of specific post-operative complications can be reviewed in Table 1. CONCLUSIONS We found no association between increasing BMI and need for reoperation or overall rate of complications from initial AUS insertion. However, obesity was associated with increased wound dehiscence, post-operative urinary tract infection, and deep vein thrombosis, although rates of these complications were quite low. Hence, AUS placement is an excellent option to treat urinary incontinence in obese patients, but special attention should be paid to optomizing perioperative antibiotic coverage, wound care, and post-operative ambulation. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e802 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Valary Raup More articles by this author Pamela Lu More articles by this author Malte Vetterlein More articles by this author Bjoern Loeppenberg More articles by this author Christian Meyer More articles by this author Quoc-Dien Trinh More articles by this author Jairam Eswara More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...