TENSION-FREE VAGINAL TAPE PROCEDURE IS AN IDEAL TREATMENT FOR OBESE PATIENTS

D. Lovatsis, MD, C. Gupta, MD, F. Lee, MD, E. Dean, MD

   Objective: To evaluate the effect of obesity on success of Tension-free Vaginal Tape (TVT) for stress urinary incontinence.

   Materials and Methods: Retrospective cohort study of 35 patient pairs who had undergone TVT in Winnipeg, Canada between Nov./99 and Aug./01. Obese patients (BMI greater than or equal to 35) were paired for age and prior continence surgery with non-obese patients (BMI less than or equal to 30). Follow-up was either by objective cough stress test or subjective cure assessed by telephone interview. A patient was considered cured if she was free of post-operative stress incontinence. Statistical analysis was by the McNamara chi-squared test for paired data.

   Results: Follow-up duration ranged from 6-24 months. There were 7 failures in total (4 in obese and 3 in non-obese patients), and this was not statistically significant (P>0.05). There were 5 bladder perforations (identified at the time of the procedure), all in non-obese patients.

   Conclusions: These data demonstrate no difference in cure of TVT in obese versus non-obese patients. Given the fewer complications, this procedure appears to be an ideal surgical treatment for stress urinary incontinence in obese patients.