Division of Urogynaecology, Department of Obstetrics and Gynaecology, University of Calgary, Calgary, AB, Canada.
Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
BJOG. 2015 Nov;122(12):1705-12. doi: 10.1111/1471-0528.13132. Epub 2014 Oct 15.
To evaluate impact of body mass index (BMI) ≥30 on objective and subjective cure rates 12 months after midurethral sling surgery.
Secondary analysis.
Three hospitals in Calgary, Canada, 2005-07.
A total of 182 women enrolled in a randomised control trial of tension-free vaginal tape versus transobturator tape.
Women were classified as obese or nonobese from height and weight on day of surgery. Women underwent postoperative standardised pad tests, self-reporting of urinary incontinence, and quality of life scores. Categorical data compared with chi-square or Fisher's exact, continuous data compared with Mann-Whitney U test.
Primary outcome was objective cure, defined as <1 g urine loss on postoperative 1-hour pad test. Secondary outcomes were subjective cure of incontinence (no stress incontinence in previous 7 days), presence of urinary urgency in previous 7 days, Urogenital Distress Inventory (UDI-6) scores, Incontinence Impact Questionnaire (IIQ-7) scores, and surgical complication rates.
Objective cure differed, with 85.6% of nonobese women leaking <1 g on 1-hour pad test, versus 67.8% of obese women (P = 0.006, risk difference [RD] 17.8%, 95% confidence interval [95% CI] 4.2-31.4%). Subjective cure was 85.8% for nonobese women versus 70.7% for obese women (P = 0.016, RD 15.1%, 95% CI 1.9-28.4%). For both groups, improvement was seen for postoperative UDI-6 (median -33.3 [-44.4 to -22.2] and -27.2 [-44.4 to -16.7]) and IIQ-7 scores (median -26.2 [-45.2 to -14.3] and -23.8 [-42.9 to -14.3]). No differences existed in rates of operative complications between the two groups.
Twelve months after midurethral sling surgery, obese women experience lower rates of cure than those who are nonobese.
评估体重指数（BMI）≥30 对中尿道吊带术后 12 个月的客观和主观治愈率的影响。
二次分析。
加拿大卡尔加里的三家医院，2005-07 年。
共纳入 182 名随机对照试验中接受无张力阴道吊带术与经闭孔吊带术的女性。
根据手术当天的身高和体重，女性被分为肥胖或非肥胖。女性接受术后标准垫试验、尿失禁自我报告和生活质量评分。分类数据采用卡方或 Fisher 确切检验比较，连续数据采用 Mann-Whitney U 检验比较。
主要结局为客观治愈率，定义为术后 1 小时垫试验中尿丢失<1g。次要结局为尿失禁的主观治愈率（过去 7 天无压力性尿失禁）、过去 7 天内是否存在尿急、尿生殖窘迫量表（UDI-6）评分、尿失禁影响问卷（IIQ-7）评分和手术并发症发生率。
客观治愈率不同，非肥胖女性中有 85.6%在 1 小时垫试验中漏尿<1g，而肥胖女性中仅有 67.8%（P=0.006，风险差异[RD]17.8%，95%置信区间[95%CI]4.2-31.4%）。非肥胖女性的主观治愈率为 85.8%，肥胖女性为 70.7%（P=0.016，RD 15.1%，95%CI 1.9-28.4%）。两组术后 UDI-6（中位数-33.3[-44.4 至-22.2]和-27.2[-44.4 至-16.7]）和 IIQ-7 评分（中位数-26.2[-45.2 至-14.3]和-23.8[-42.9 至-14.3]）均有改善。两组手术并发症发生率无差异。
中尿道吊带术后 12 个月，肥胖女性的治愈率低于非肥胖女性。
