Body mass index and outcome of insitu vaginal wall sling surgery
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Tarih
2004
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Introduction: In this study, we aimed to analyse whether body mass index (BMI) have a negative impact on the outcome of insitu vaginal wall sling surgery for Type II stress urinary incontinence. Materials and Methods: The results of modified insitu vaginal wall sling in 29 women with an average age of 54.8 years and a parity rate of 2.58 having a Body Mass Index (BMI) between 18-25 kg/m2 were compared statistically with the results of 22 women with an average age of 56.9 years and a parity rate of 2.27 having a body mass index of 25-30 kg/m2 by using Chi Square test to assess whether preoperative overweight has a negative impact on surgical outcome of our technique. There was no patient in the obese group with a body mass index of more than 30 kg/m2. Preoperative evaluations included history, pet usage per day, parity rate and frequency, urgency, urgency incontinence questionnaire. Physical examinations included vaginal examination in lithotomy position to assess the condition and the accompanying pathologies such as cystocele, rectocele and enterocele, Q tip test to assess the degree of urethral mobility, cystoscopic examination to rule out intravesical pathologies such as carcinoma insitu, neoplasms and interstitiel cystitis followed by Bonney test, urodynamic examination by using Andromeda Elipse 4 multichannel cystometry and only the patients who met type II stress incontinence definition were included to the study. Body mass index was calculated by dividing the body weight in kilograms to the square of the length of the patient in meters. The patients with the body mass index of 18.5-25 kg/m2 were accepted as normal weight and 25-30 kg/m2 were accepted as overweight. All patients were operated by using a modified insitu vaginal wall sling procedure between the periods of 1996 to 2002 and followed with an average follow-up period of 28.7 (12-62) months. In our technique a rectangular vaginal wall sling incision 3x2 cm was made corresponding to the level of bladder neck and it was dissected of the surrounding vaginal wall. Two polypropylene 1-0 sutures were passed on the short sides of the rectangle as coil fashion and transferred to the suprapubic region by two bended kishner needles. The dissected vaginal wall was sutured onto the rectangular sling to cover it by two layers to reinforce its strength. Prolene sutures were tied as cross manner on the rectus fascia and urethral catheter was taken on the fifth postoperative day. The cure was defined as no more pet usage in any condition, improvement as the decrease of the pet usage more than 50% and failure it incontinence persists despite surgery. Results: There were no statistical difference between the parity of the two groups and no statistical difference between the ages of the groups. In patients whom modified insitu vaginal wall sling were performed for type II stress incontinence, the cure, improvement and failure rates in normal weight group (BMI 18-25 kg/m2) were found as 75.8%, 69% and 17.3% respectively while the results in overweight group (BMI 25-30 kg/m2) were 72.7%, 9.2% and 18.2%. respectively. There were no significant difference in the surgical outcomes between the two groups (p<0.05). Conclusions: We didn't find the preoperative overweight to be a risk factor for the failures of modified insitu vaginal wall sling operations that were followed for about 28 months when compared to normal weight group.
Açıklama
Anahtar Kelimeler
Body mass index, Urinary incontinence surgery
Kaynak
Turk Uroloji Dergisi
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
30
Sayı
2
