title: The very obese woman and the very old woman: tension-free vaginal tape for the treatment of stress urinary incontinence.
abstract: A mailed questionnaire was sent to 970 consecutive women who underwent a tension-free vaginal tape (TVT) procedure between 1995 and 2001 at the Department of Obstetrics and Gynecology in Falun Hospital. Seven hundred and sixty (78.4%) women responded. The outcome was compared between women older than 75 years (n=113) and younger women, and between women with a body mass index (BMI) above 35 (n=61) and those who had normal weight. Mean follow-up was 5.7 years. Thirty-six elderly women and one of the obese women were deceased at the long-term follow-up. TVT was easy to perform and was a safe procedure for women in all groups. There was a sharp decrease in cure rate of any urinary incontinence problems among women aged 75 years or more (55.7%), as compared to those who were younger (79.7%). The cure rate moderately decreased from BMI groups 19-24 to 30-34. BMI > or =35 seemed to be the best explanatory cutoff level. The overall cure rate in women of normal weight was 81.2%, as compared to 52.1% in the very obese. The cure rate for urinary incontinence with tension-free vaginal tape in women above 75 years of age and in women with a BMI above 35 was acceptable, but lower as compared to the remaining study population.
authors.affiliation: Department of Obstetrics and Gynecology, Falun Hospital, 791 82, Falun, Sweden. dan.hellberg@ltdalarna.se
authors.forename: Dan
authors.initials: D
authors.lastname: Hellberg
authors.forename: Corinne
authors.initials: C
authors.lastname: Holmgren
authors.forename: Lars
authors.initials: L
authors.lastname: Lanner
authors.forename: Staffan
authors.initials: S
authors.lastname: Nilsson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects*