Impact of Weight Gain on Surgical Outcomes and Quality of Life among Women after Sling Surgeries.

ABSTRACT

STUDY OBJECTIVE: To investigate the impact of body weight gain after sling surgeries on outcomes in women with stress urinary incontinence. DESIGN: A single-center, retrospective study. SETTING: Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taiwan. PATIENTS A total of 248 women who underwent sling surgeries from 2010 to 2015 were reviewed. Patients who gained more than 10% body weight were compared with those with stable body weight. INTERVENTIONS: Midurethral sling surgery with single-incision, transobturator, or retropubic slings. MEASUREMENTS AND MAIN RESULTS: Objective success was defined as no urine leakage during the stress test in the filling phase of urodynamic studies. De novo overactive bladder (OAB) was defined as the appearance of urgency, frequency, and/or nocturia, with or without urinary incontinence after midurethral sling surgery persisting after 6 months. Quality of life evaluations included the short forms of the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7. A total of 248 women who underwent sling surgeries and had complete weight measurement and evaluation data before and after the surgeries were included, of whom 47 gained body weight, and 201 had a stable body weight. The median follow-up duration was 18 months (range, 6-47 months). There were no significant differences in surgical outcomes between the 2 groups regarding objective cure rate (86% vs 87%, p = .834), 1-hour pad test (4.5 ± 17.8 vs 3.6 ± 18.6 g, p = .770), or postoperative quality of life (Urogenital Distress Inventory-6 1.9 ± 2.8 vs 2.8 ± 3.2, p = .122; Incontinence Impact Questionnaire-7 1.8 ± 3.9 vs 2.6 ± 4.3, p = .307). A trend toward increased de novo OAB rate was observed, although this finding was not adequately powered. CONCLUSION: Weight gain after sling surgeries did not influence surgical outcomes, but there was a nonsignificant trend toward increased OAB in the weight gain group. It may be beneficial to counsel patients with regard to body weight maintenance after sling surgeries.