Rafii Arash, Daraï Emile, Haab François, Samain Emmanuel, Levardon Michel, Deval Bruno
Services de Gynécologie, Hôpital Hôtel-Dieu, Hôpital Beaujon, Clichy, et Hôpital Tenon, Assistance Publique-Hopitaux de Paris (AP-HP), Université Paris 7, 100 Boulevard du Général Leclerc, Clichy 92110, France.
Eur Urol. 2003 Mar;43(3):288-92. doi: 10.1016/s0302-2838(03)00009-5.
To assess the effectiveness of tension-free vaginal tape (TVT) in women with high body mass indices (BMIs).
Thirty-eight consecutive patients with BMIs exceeding 30 who underwent tension-free vaginal tape were compared with 149 consecutive patients with BMIs of 30 or less who underwent the same procedure. Body mass index was calculated pre-operatively and at follow-up. Women were classified as being of normal weight (BMI 20-25), overweight (BMI 26-30), or obese (BMI >30). Patient characteristics, operative and post-operative complications, reported continence rates were analyzed according to BMI.
There were no significant differences between groups in terms of age, parity, menopausal status, previous surgery, type and degree of incontinence. Estimated blood loss, operative times, bladder injuries, post-operative urgency and voiding disorders did not differ significantly between women with high BMIs and those with low BMIs. Women with BMIs exceeding 30 had a significantly higher incidence of post-operative urge urinary incontinence (17.9 versus 3.4 and 6.4% p = 0.02) without any effects on the objective and subjective cure rates (82 versus 88.7 and 93% p = 0.1, 71.7 versus 72.1 and 74% p = 0.9).
We did not find pre-operative obesity to be a risk factor for failure of tension-free vaginal tape.
评估无张力阴道吊带术（TVT）对高体重指数（BMI）女性的有效性。
将38例连续接受无张力阴道吊带术且BMI超过30的患者与149例连续接受相同手术且BMI为30或更低的患者进行比较。术前及随访时计算体重指数。女性被分为体重正常（BMI 20 - 25）、超重（BMI 26 - 30）或肥胖（BMI > 30）。根据BMI分析患者特征、手术及术后并发症、报告的控尿率。
两组在年龄、产次、绝经状态、既往手术史、尿失禁类型及程度方面无显著差异。高BMI女性与低BMI女性在估计失血量、手术时间、膀胱损伤、术后尿急及排尿障碍方面无显著差异。BMI超过30的女性术后急迫性尿失禁发生率显著更高（17.9% 对比3.4%和6.4%，p = 0.02），但对客观和主观治愈率无任何影响（82%对比88.7%和93%，p = 0.1；71.7%对比72.1%和74%，p = 0.9）。
我们未发现术前肥胖是无张力阴道吊带术失败的危险因素。
