Zivkovic F, Tamussino K, Pieber D, Haas J
Department of Obstetrics and Gynecology, University of Graz, Austria.
Obstet Gynecol. 1999 May;93(5 Pt 1):753-6. doi: 10.1016/s0029-7844(98)00513-4.
To analyze the influence of body mass on the outcome of surgery for urinary incontinence.
Among 291 women operated on for stress incontinence, 187 (64%) were available for follow-up at 5 years. Eighty women had anterior colporrhaphy, 49 anterior colporrhaphy with needle suspension of the bladder neck, and 58 Burch colposuspension. Body mass index was calculated preoperatively and at follow-up. Women were classified as being of normal weight (body mass index [BMI] 20-25), overweight (BMI 26-30), or obese (BMI greater than 30). Reported continence rates were analyzed according to BMI for each operation and the BMIs of continent patients were compared with those of incontinent patients.
The continence rates at 5-year follow-up for anterior colporrhaphy, anterior colporrhaphy with needle suspension of bladder neck, and Burch colposuspension were 58, 51, and 86%, respectively (P < .001). The continence rates did not differ significantly among the three BMI groups for each procedure. A statistical power of 26% was found for the hypothesis that the outcome of the procedures does not depend on BMI. The preoperative and postoperative BMIs of continent and incontinent women for each procedure did not differ significantly.
We did not find preoperative obesity to be a risk factor for failure of incontinence surgery, but the power of our study was limited.
分析体重对尿失禁手术疗效的影响。
在291例行压力性尿失禁手术的女性中，187例（64%）在5年后接受随访。80例行阴道前壁修补术，49例行阴道前壁修补术加膀胱颈穿刺悬吊术，58例行Burch阴道悬吊术。术前及随访时计算体重指数。女性被分为体重正常（体重指数[BMI]20 - 25）、超重（BMI 26 - 30）或肥胖（BMI大于30）。根据每种手术的BMI分析报告的控尿率，并比较控尿患者与尿失禁患者的BMI。
阴道前壁修补术、阴道前壁修补术加膀胱颈穿刺悬吊术和Burch阴道悬吊术5年随访时的控尿率分别为58%、51%和86%（P <.001）。每种手术的三个BMI组之间的控尿率无显著差异。对于手术疗效不取决于BMI这一假设，发现统计效能为26%。每种手术的控尿和尿失禁女性术前及术后的BMI无显著差异。
我们未发现术前肥胖是尿失禁手术失败的危险因素，但本研究的效能有限。
