PURPOSE: Obese women (body mass index 30 kg/m2 or greater) are considered to be at risk for postoperative complications and failure after stress incontinence surgery. We compare the outcomes in this population with nonobese women (body mass index less than 30 kg/m2) undergoing rectus fascia, porcine dermis and polypropylene sling procedures. MATERIALS AND METHODS: We retrospectively identified 412 women with a body mass index less than 30 kg/m2 (94 autologous rectus fascia, 157 acellular porcine dermis, 161 transobturator polypropylene mid urethral sling) and 297 with a body mass index of 30 kg/m2 or greater (66 autologous rectus fascia, 114 acellular porcine dermis, 117 transobturator polypropylene mid urethral sling) who underwent sling procedures and other pelvic surgery. Evaluation included SEAPI assessment and quality of life questionnaires. Global cure equaled subjective SEAPI composite=0 and subjective satisfaction. Stress urinary incontinence cure equaled SEAPI (S)=0 and negative cough stress test. Chart review for perioperative data was conducted. Groups and outcomes were statistically compared. RESULTS: All women had a minimum followup of 12 months. After controlling for body mass index preoperative demographics, SEAPI scores and quality of life indices were not statistically different within each sling group. Global cure and stress urinary incontinence cure rates were significantly higher for nonobese women in each sling group. Statistically significant improvement in SEAPI scores and quality of life indices was achieved for all groups, and there were no statistical differences within each sling group. Overall obese women had no increase in complications compared with nonobese women. The incidence of obstructive sequelae was statistically higher in nonobese women undergoing autologous rectus fascia and transobturator polypropylene mid urethral sling procedures. CONCLUSIONS: Although cure rates are lower, obese women have significant improvements in quality of life after surgery for stress urinary incontinence. Obesity does not appear to be a risk factor for additional complications during sling and prolapse surgery.
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机译：目的：肥胖妇女（体重指数30 kg / m2或更高）被认为在压力性失禁手术后有发生术后并发症和衰竭的风险。我们将这些人群与接受直肌筋膜，猪真皮和聚丙烯吊带手术的非肥胖女性（体重指数低于30 kg / m2）进行比较。材料与方法：我们回顾性分析了412例体重指数低于30 kg / m2（94例自体直肌筋膜，157例无细胞猪真皮，161例经闭孔聚丙烯中段尿道吊带）和297例体重指数低于30 kg / m2的妇女。接受吊索手术和其他骨盆手术的患者或以上（66例自体直肌筋膜，114例脱细胞猪真皮，117例经闭孔聚丙烯中段尿道吊带）。评估包括SEAPI评估和生活质量问卷。总体治愈等于主观SEAPI复合= 0和主观满意度。压力性尿失禁治疗等于SEAPI（S）= 0，且咳嗽压力测试为阴性。进行围手术期数据图表审查。分组和结果进行统计学比较。结果：所有妇女至少随访12个月。在控制了体重指数的术前人口统计学特征之后，每个悬带组的SEAPI得分和生活质量指数均无统计学差异。在每个吊带组中，非肥胖女性的总体治愈率和压力性尿失禁治愈率均明显更高。所有组的SEAPI得分和生活质量指数均达到统计学上的显着提高，并且每个吊索组之间均无统计学差异。与非肥胖妇女相比，总体肥胖妇女的并发症没有增加。在非肥胖女性中，自体直肌筋膜和经尿道聚丙烯中段输尿管吊带术的非肥胖女性，阻塞性后遗症的发生率在统计学上较高。结论：尽管治愈率较低，但肥胖妇女在因压力性尿失禁而手术后的生活质量上有显着改善。肥胖似乎不是吊带和脱垂手术期间其他并发症的危险因素。
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