The Outcome of a Single-Incision Sling versus Trans-Obturator Sling in Overweight and Obese Women with Stress Urinary Incontinence at 3-Year Follow-Up
Abstract
:1. Introduction
2. Experimental Section
3. Results
4. Discussion
5. Conclusions
Author Contributions
Conflicts of Interest
References
- Abrams, P.; Cardozo, L.; Fall, M.; Griffiths, D.; Rosier, P.; Ulmsten, U.; Van Kerrebroeck, P.; Victor, A.; Wein, A. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 2003, 61, 37–49. [Google Scholar] [CrossRef]
- Almousa, S.; Van Loon, A.B. The prevalence of urinary incontinence in nulliparous adolescent and middle-aged women and the associated risk factors: A systematic review. Maturitas 2018, 107, 78–83. [Google Scholar] [CrossRef] [PubMed]
- Mommsen, S.; Foldspang, A. Body mass index and adult female urinary incontinence. World J. Urol. 1994, 12, 319–322. [Google Scholar] [CrossRef] [PubMed]
- Subak, L.L.; Richter, H.E.; Hunskaar, S. Obesity and Urinary Incontinence: Epidemiology and Clinical Research Update. J. Urol. 2009, 182, S2–S7. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- World Health Organization Media Centre. Obesity and Overweight, Fact Sheet No. 311. Available online: http://www.who.int/mediacentre/factsheets/fs311/en/index.html (accessed on 30 June 2019).
- Noblett, K.L.; Jensen, J.K.; Ostergard, D.R. The relationship of body mass index to intra-abdominal pressure as measured by multi-channel cystometry. Int. Urogynecol. J. Pelvic Floor Dysfunct. 1997, 8, 323–326. [Google Scholar] [CrossRef] [PubMed]
- Morán, E.; Pérez-Ardavín, J.; Sánchez, J.V.; Bonillo, M.A.; Martínez-Cuenca, E.; Arlandis, S.; Broseta, E.; Boronat, F.; Ardavín, J. Mid-term safety and efficacy of the ALTIS® single-incision sling for female stress urinary incontinence: less mesh, same results. BJU Int. 2018, 123, E51–E56. [Google Scholar] [CrossRef] [PubMed]
- Schimpf, M.O.; Rahn, D.D.; Wheeler, T.L.; Patel, M.; White, A.B.; Orejuela, F.J.; El-Nashar, S.A.; Margulies, R.U.; Gleason, J.L.; Aschkenazi, S.O.; et al. Sling surgery for stress urinary incontinence in women: A systematic review and metaanalysis. Am. J. Obstet. Gynecol. 2014, 211, 71.e1–71.e27. [Google Scholar] [CrossRef] [PubMed]
- Brennand, E.A.; Tang, S.; Williamson, T.; Birch, C.; Murphy, M.; Robert, M.; Ross, S. Twelve-month outcomes following midurethral sling procedures for stress incontinence: impact of obesity. BJOG 2015, 122, 1705–1712. [Google Scholar] [CrossRef]
- Liu, P.E.; Su, C.H.; Lau, H.H.; Chang, R.J.; Huang, W.C.; Su, T.H. Outcome of tension-free obturator tape procedures in obese and overweight women. Int. Urogynecol. J. 2011, 22, 259–263. [Google Scholar] [CrossRef]
- Frigerio, M.; Regini, C.; Manodoro, S.; Spelzini, F.; Milani, R. Mini-sling efficacy in obese versus non-obese patients for treatment of stress urinary incontinence. Minerva Ginecol. 2017, 69, 533–537. [Google Scholar]
- Meschia, M.; Rossi, G.; Bertini, S.; Sommacal, A.; Foina, S.; Sandretti, F.; Barbacini, P. Single incision mid-urethral slings: impact of obesity on outcomes. Eur. J. Obstet. Gynecol. Reprod. Boil. 2013, 170, 571–574. [Google Scholar] [CrossRef]
- Uebersax, J.S.; Wyman, J.F.; Shumaker, S.A.; McClish, D.K. Continence Program for Women Research Group Short forms to assess life quality and symptom distress for urinary incontinence in women: The incontinence impact questionnaire and the urogenital distress inventory. Neurourol. Urodyn. 1995, 14, 131–139. [Google Scholar] [CrossRef]
- Su, T.-H.; Lau, H.-H.; Su, T.; Lau, H. Validation of a Chinese Version of the Short Form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. J. Sex. Med. 2010, 7, 3940–3945. [Google Scholar] [CrossRef]
- Oliveira, R.; Botelho, F.; Silva, P.; Resende, A.; Silva, C.; Dinis, P.; Cruz, F. Single-incision sling system as primary treatment of female stress urinary incontinence: prospective 12 months data from a single institution. BJU Int. 2011, 108, 1616–1621. [Google Scholar] [CrossRef] [PubMed]
- Anding, R.; Schoen, M.; Kirschner-Hermanns, R.; Fisang, C.; Müller, S.C.; Latz, S. Minimally invasive treatment of female stress urinary incontinence with the adjustable single-incision sling system (AJUST™) in an elderly and overweight population. Int. Braz. J. Urol. 2017, 43, 280–288. [Google Scholar] [CrossRef] [PubMed]
- Nambiar, A.; Cody, J.D.; Jeffery, S.T.; Aluko, P. Single-incision sling operations for urinary incontinence in women. Cochrane Database Syst Rev. 2017, 7, CD008709. [Google Scholar] [CrossRef] [PubMed]
Single-Incision Sling (n = 106) | Trans-Obturator Sling (n = 111) | p | |
---|---|---|---|
Age (years) | 55.9 ± 11.1 | 54.3 ± 9.0 | 0.421 |
Parity (n) | 3.1 ± 1.3 | 3.3 ± 1.6 | 0.552 |
Body mass index (kg/m2) | 28.9 ± 5.6 | 29.5 ± 6.1 | 0.857 |
Postmenopausal status (n) | 42 (43%) | 37 (41%) | 0.318 |
Previous prolapse repair surgery (n) | 21 (20%) | 31 (29%) | 0.113 |
Intrinsic sphincter deficiency (n) | 9 (8%) | 12 (11%) | 0.365 |
Hormonal therapy (n) | 6 (6%) | 8 (9%) | 0.521 |
1-hour pad test (g) | 49.8 ± 49.5 | 40.9 ± 29.3 | 0.329 |
Quality of life | |||
UDI-6 | 29.8 ± 17.6 | 31.4 ± 18.9 | 0.377 |
IIQ-7 | 25.9 ± 16.4 | 27.7 ± 20.8 | 0.238 |
PISQ-12 | 34.5 ± 16.2 | 33.6 ± 15.6 | 0.711 |
Single-Incision Sling (n = 72) | Trans-Obturator Sling (n = 71) | p | |
---|---|---|---|
Objective cure (n) | 64 (89%) | 62 (87%) | 0.488 |
Subjective cure (n) | 66 (92%) | 64 (91%) | 0.489 |
De novo urgency (n) | 6 (8%) | 8 (11%) | 0.272 |
De novo voiding difficulty (n) | 3 (4%) | 5 (7%) | 0.352 |
1-hour pad test (g) | 3.0 ± 18.4 | 3.3 ± 15.1 | 0.361 |
Quality of life | |||
UDI-6 | 2.7 ± 2.1 | 3.2 ± 3.3 | 0.473 |
IIQ-7 | 2.1 ± 3.9 | 3.3 ± 4.8 | 0.257 |
PISQ-12 | 37.8 ± 19.1 | 36.2 ± 16.3 | 0.896 |
Single-Incision Sling (n = 34) | Trans-Obturator Sling (n = 40) | p | |
---|---|---|---|
Objective cure (n) | 26 (76%) | 32 (80%) | 0.465 |
Subjective cure (n) | 27 (79%) | 34 (85%) | 0.372 |
De novo urgency (n) | 3 (9%) | 3 (8%) | 0.582 |
De novo voiding difficulty (n) | 1 (3%) | 3 (8%) | 0.371 |
1-hour pad test (g) | 9.2 ± 27.5 | 3.6 ± 16.5 | 0.047 |
Quality of life | |||
UDI-6 | 6.7 ± 2.0 | 3.0 ± 3.3 | <0.001 |
IIQ-7 | 6.1 ± 7.9 | 6.2 ± 5.9 | 0.573 |
PISQ-12 | 30.7 ± 17.1 | 29.1 ± 16.0 | 0.479 |
Single-Incision Sling (n = 106) | Trans-Obturator Sling (n = 111) | p | |
---|---|---|---|
Operation time (min) | 7.9 ± 3.7 | 9.1 ± 3.5 | 0.017 |
Blood loss (mL) | 5.8 ± 3.3 | 6.2 ± 3.4 | 0.343 |
Hospital stay (day) | 1.5 ± 1.0 | 1.7 ± 0.5 | 0.458 |
Bladder perforation (n) | 3 (3%) | 5 (5%) | 0.387 |
Pain (VAS score) | 0.5 ± 0.9 | 1.5 ± 2.1 | <0.001 |
Urinary tract infection (n) | 6 (6%) | 5 (5%) | 0.468 |
Wound hematoma (n) | 0 (0%) | 3 (3%) | 0.132 |
Temporal urine retention treated with catheter (n) * | 3 (3%) | 5 (4%) | 0.526 |
Single-Incision Sling | Overweight Patients (n = 72) | Obese Patients (n = 34) | p |
Objective cure (n) | 64 (89%) | 26 (76%) | 0.068 |
Subjective cure (n) | 66 (92%) | 27 (79%) | 0.058 |
1-hour pad test (g) | 3.0 ± 18.4 | 9.2 ± 27.5 | <0.001 |
Trans-Obturator Sling | Overweight Patients (n = 71) | Obese Patients (n = 40) | p |
Objective cure (n) | 62 (87%) | 32 (80%) | 0.250 |
Subjective cure (n) | 64 (91%) | 34 (85%) | 0.175 |
1-hour pad test (g) | 3.3 ± 15.1 | 3.6 ± 16.5 | 0.493 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Lau, H.-H.; Enkhtaivan, S.; Su, T.-H.; Huang, W.-C. The Outcome of a Single-Incision Sling versus Trans-Obturator Sling in Overweight and Obese Women with Stress Urinary Incontinence at 3-Year Follow-Up. J. Clin. Med. 2019, 8, 1099. https://doi.org/10.3390/jcm8081099
Lau H-H, Enkhtaivan S, Su T-H, Huang W-C. The Outcome of a Single-Incision Sling versus Trans-Obturator Sling in Overweight and Obese Women with Stress Urinary Incontinence at 3-Year Follow-Up. Journal of Clinical Medicine. 2019; 8(8):1099. https://doi.org/10.3390/jcm8081099
Chicago/Turabian StyleLau, Hui-Hsuan, Sugarmaa Enkhtaivan, Tsung-Hsien Su, and Wen-Chu Huang. 2019. "The Outcome of a Single-Incision Sling versus Trans-Obturator Sling in Overweight and Obese Women with Stress Urinary Incontinence at 3-Year Follow-Up" Journal of Clinical Medicine 8, no. 8: 1099. https://doi.org/10.3390/jcm8081099