title: Tension-free vaginal tape (TVT) in morbidly obese patients with severe urodynamic stress incontinence as last option treatment.
abstract: OBJECTIVE
  To determine the safety and efficacy of tension-free vaginal tape (TVT) in morbidly obese women with severe urodynamic stress incontinence (USI) as last option treatment.
  
  
  METHODS
  Thirty-one patients with body mass index (BMI) >40 kg/m2, who had undergone the TVT procedure for urodynamically-confirmed USI were matched with 52 patients with BMI <30 kg/m2 who underwent the same procedure. BMI was calculated at the time of the surgery. Patients' characteristics and surgical data, complications and cure rates were analyzed for both groups.
  
  
  RESULTS
  After a mean follow-up of 18.5 (range: 12-24) months the continence rates were 87% and 92% for morbidly obese women and control group, respectively (p = 0.103). No serious intraoperative complications were noted in both groups. However, the early postoperative complications were significantly higher (p < 0.05) in morbidly obese patients. In 4 patients from both group long term postoperative catheterization was necessary for 4 weeks. In one patient (2%) from the control group dilatation of urethra took place. No defect in healing or rejection of the tape occurred.
  
  
  CONCLUSIONS
  TVT is a minimal invasive and safe procedure for morbidly obese patients suffering from severe USI with good outcome. Preoperative morbid obesity does not seem to be a risk factor for failure of this procedure.
authors.affiliation: Department of Urology and pediatric Urology, Northwest Hospital, Stiftung Hospital zum Heiligen Geist, Frankfurt am Main, Germany. k_skriapas@gmx.de
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Skriapas
authors.forename: Vassilis
authors.initials: V
authors.lastname: Poulakis
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dillenburg
authors.forename: Rachelle
authors.initials: R
authors.lastname: de Vries
authors.forename: Ulrich
authors.initials: U
authors.lastname: Witzsch
authors.forename: Michael
authors.initials: M
authors.lastname: Melekos
authors.forename: Eduard
authors.initials: E
authors.lastname: Becht
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures; D014621:Vagina / Q000601:surgery*