Bradley Catherine S, Kenton Kimberly S, Richter Holly E, Gao Xin, Zyczynski Halina M, Weber Anne M, Nygaard Ingrid E
Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Am J Obstet Gynecol. 2008 Dec;199(6):690.e1-8. doi: 10.1016/j.ajog.2008.07.030. Epub 2008 Oct 9.
The purpose of this study was to compare outcomes after sacrocolpopexy (SC) between obese and healthy-weight women.
Baseline and postoperative data were analyzed from the Colpopexy And Urinary Reduction Efforts (CARE) randomized trial of SC with or without Burch colposuspension in stress continent women with stages II-IV prolapse. Outcomes and complications were compared between obese and healthy-weight women.
CARE participants included 74 obese (body mass index >/=30 kg/m(2)), 122 overweight (25-29.9 kg/m(2)), and 125 healthy-weight (18.5-24.9 kg/m(2)) women, and 1 underweight (< 18.5 kg/m(2)) woman. Compared to healthy-weight women, obese women were younger (59.0 +/- 9.9 vs 62.1 +/- 10.3 yrs; P = .04), more likely to have stage II prolapse (25.7% vs 11.2%; P = .01), and had longer operative times (189 +/- 52 vs 169 +/- 58 min; P = .02). Two years after surgery, stress incontinence, prolapse, symptom resolution, and satisfaction did not differ between the obese and healthy-weight groups.
Most outcomes and complication rates after SC are similar in obese and healthy-weight women.
本研究旨在比较肥胖女性与体重正常女性行骶骨阴道固定术（SC）后的结局。
对盆底修复与尿失禁改善（CARE）随机试验的基线和术后数据进行分析，该试验纳入了患有II-IV期脱垂的压力性尿失禁女性，她们接受了SC手术，部分还接受了Burch阴道悬吊术。比较肥胖女性与体重正常女性的结局和并发症情况。
CARE试验参与者包括74名肥胖女性（体重指数≥30kg/m²）、122名超重女性（25-29.9kg/m²）、125名体重正常女性（18.5-24.9kg/m²）以及1名体重过轻女性（<18.5kg/m²）。与体重正常女性相比，肥胖女性更年轻（59.0±9.9岁 vs 62.1±10.3岁；P = 0.04），更有可能患有II期脱垂（25.7% vs 11.2%；P = 0.01），且手术时间更长（189±52分钟 vs 169±58分钟；P = 0.02）。术后两年，肥胖组与体重正常组在压力性尿失禁、脱垂、症状缓解及满意度方面并无差异。
肥胖女性与体重正常女性行SC术后的大多数结局和并发症发生率相似。
