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Does Body Mass Index Impact Passing Voiding Trial After Midurethral Sling Procedures for Stress Urinary Incontinence?

Huffaker, R. Keith MD; Livers, Nathan MD; Yandell, Paul M. MD; Shull, Bobby L. MD; Muir, Tristi W. MD; Kuehl, Thomas J. PhD; Bird, Erin T. MD

Female Pelvic Medicine & Reconstructive Surgery: November/December 2010 - Volume 16 - Issue 6 - pp 358-361
doi: 10.1097/SPV.0b013e3181ff394e
Original Articles
Journal Club

Objective: To test the hypothesis that body mass index (BMI) is a factor associated with passing a voiding trial after midurethral sling procedures for stress urinary incontinence (SUI).

Study Design: The medical records of 136 consecutive patients who underwent placement of either tension-free vaginal tape (TVT) or transobturator tape (TOT) for SUI during a 1-year period (September 1, 2007 to August 31, 2008) were retrospectively reviewed. Variables assessed were BMI, age, and passing or failing a postoperative urinary voiding trial. Patients with concomitant pelvic organ prolapse surgeries were not included in this analysis.

Results: Sixty-seven patients underwent TVT, whereas 69 had TOT procedures. In the TVT group, 30 patients (42%) were unable to void immediately postoperatively compared with 11 patients (16%) in the TOT group (P = 0.0003). The mean (SD) age and BMI of patients who failed or passed voiding trials was 58.6 (12.0) years and 28.0 (4.9) kg/m2 or 53.5 (12.3) years and 29.8 (5.7) kg/m2, respectively. Of 38 patients who did not pass a voiding trial on the day of the procedure, 31 (82%) passed on postoperative day 1, and all patients had passed a voiding trial by postoperative day 11. The mean (SD) BMI for 7 patients who did not pass voiding trial by postoperative day 1 was 28.3 (5.2) kg/m2.

Conclusions: Women with higher BMIs were more likely to pass voiding trials after midurethral sling procedures. Patients who had TOT placement had greater success passing a postprocedure voiding trial than did patients who had TVT placement.

In this study, a patient's ability to pass a postoperative voiding trial after midurethral sling placement was affected by body mass index.

From the *Quillen ETSU Center for Pelvic Surgery and Urogynecology, Department of Obstetrics and Gynecology, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN; †Department of Obstetrics & Gynecology, Scott and White Memorial Hospital & Clinic; ‡Section of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, Scott and White Memorial Hospital & Clinic, Temple; §Section of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston; ∥Molecular & Cellular Medicine, Texas A&M Health Science Center College of Medicine; and ¶Department of Urology, Scott and White Memorial Hospital and Clinic, Temple, TX.

Reprints: R. Keith Huffaker, MD, Quillen ETSU Center for Pelvic Surgery and Urogynecology, Department of Obstetrics and Gynecology, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614. E-mail: khuffake@yahoo.com.

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