Objective efficacy of the tension‐free vaginal tape in obese/morbidly obese women versus non‐obese women, at median five year follow up. (17th August 2016)

• Record Type: Journal Article
• Authors: McKenna, Joanne B.; Parkin, Katrina; Cheng, Ying; Moore, Kate H.
• Is Part Of: Australian and New Zealand journal of obstetrics and gynaecology. Volume 56:Number 6(2016:Dec.)
• Page Start: 628
• Page End: 632
• Publication Date: 2016-08-17
• Subjects: Long‐term follow up -- morbid obesity -- obesity -- stress urinary incontinence -- tension‐free vaginal tape; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618.05
• DOI: 10.1111/ajo.12516
• Languages: English
• ISSNs: 0004-8666

Abstract

Abstract : Background: One subjective long‐term evaluation of the tension‐free vaginal tape (TVT) success rate in obese women showed a worse prognosis in the obese, but objective studies have been limited to short‐term follow‐up (less than two years). Aim: To determine whether the long‐term objective cure rate in obese/morbidly obese women who underwent TVT was reduced, compared to non‐obese women (at five or more years). Materials and methods: Body mass index (BMI) was collected on patients undergoing TVT procedure. Recruited patients were asked to perform a 24 h pad test and complete an International Consultation on Incontinence Questionnaire Short Form (ICIQ‐SF) at five years postoperatively. Data was analyzed according to pre‐operative urodynamic diagnoses and BMI, using 'routine' and 'strict' objective definitions of objective cure. Results: At median follow‐up of 64 months (interquartile range 58–80 months), 136 patients returned a pad test and ICIQ‐SF. Using a routine definition of cure (pad test of ≤10 g in a 24 h period), 96% of patients were cured overall. The BMI results ( n = 119 patients) were stratified into ≤25, 25.1–35 and ≥35.1 kg/m 2, which represented 41, 53 and 6% of patients, respectively. The routine cure rates for these three groups were 98, 97 and 71%, respectively ( P = 0.004). Conclusion: Long‐term objective outcomes of the TVT in morbidly obese women are significantly poorer than in women with a normal BMI.