Clinical impact of body mass index on the outcome of the SPARC-sling system for the treatment of female stress urinary incontinence.

PURPOSE

Of this observational study was to evaluate the clinical outcome of the suprapubic arc (SPARC)-sling system in women with stress urinary incontinence according to body mass index (BMI).

MATERIALS AND METHODS

A total of 151 women underwent SPARC between June 2001 and March 2009 at a single tertiary academic center. A complete urodynamic investigation was performed preoperatively. A minimum follow-up of 12 months was required, which left data of 93 individuals for analyses. Participants were divided into the following: A, non-obese (BMI 18.5 to <25 kg/m(2)), B, overweight (BMI 25 to <30 kg/m(2)), and C, obese (BMI 30-35 kg/m(2)). Objective and subjective cure rates, as well as overall success rate and self-perceived severity of bother, were measured. Moreover, participants were asked about their satisfaction after surgery.

RESULTS

Median follow-up was 7.6 years. Mean number of pads/day, pad test, and self-perceived severity of bother were significantly reduced overall, as well as in each BMI category (P < 0.001). In multivariable analyses, BMI was not an independent predictor of objective cure rate, coded either as continuous (P = 0.108) or as categorical variable (P for trend 0.301). Similarly, BMI was not an independent predictor of subjective cure rate, both coded as continuous (P = 0.475) and as categorical variable (P for trend 0.690). Overall, 92% (A), 85% (B), and 80% (C) of participants were satisfied with the surgical outcome at follow-up, respectively.

CONCLUSIONS

BMI failed to achieve independent predictor status regarding objective and subjective cure rate at follow-up. A high BMI is not a contraindication to SPARC, more studies are recommended to confirm these findings.