title: Two-year evaluation of the MiniArc in obese versus non-obese patients for treatment of stress urinary incontinence.
abstract: OBJECTIVE
  Obesity is a well-established risk factor of stress urinary incontinence, which affects up to 35% of adult women worldwide. We evaluated whether there is a difference in outcomes with MiniArc sling for treatment of stress incontinence in obese women versus non-obese women at 24 months.
  
  
  METHODS
  A 2-year subanalysis of obese (body mass index >30 kg/m(2) ) versus non-obese patients enrolled into a multicenter, prospective study evaluating the effectiveness of MiniArc sling was carried out. Qualitative (Urogenital Distress Inventory 6 and Incontinence Impact Questionnaire 7) and quantitative measurements, including the cough stress test, were carried out. Secondary outcome measures included procedure time, estimated blood loss, length of stay, perioperative complications, Wong-Baker Faces Pain Scale and adverse events.
  
  
  RESULTS
  Of 188 patients, 62 were obese. The mean procedure time, blood loss and length of stay were no different between groups. Obese patients reported significantly more pain immediately postoperatively (2 vs 1, Wong-Baker, P = 0.042), but there was no difference at postoperative day 7. There was no difference in objective cure using the cough stress test (81% obese vs 86% non-obese; P = 0.449). Urogenital Distress Inventory 6 and Incontinence Impact Questionnaire 7 median scores showed no difference between groups in improvement (P = 0.126 and P = 0.087, respectively). No serious device-related complications were reported in either group.
  
  
  CONCLUSIONS
  The MiniArc sling represents a safe and effective treatment option for both obese and non-obese patients with stress incontinence. Comparable outcomes at 2 years can be obtained in terms of cure rates using the cough stress test or questionnaires, as well as complication rates.
authors.affiliation: Atlanta Urogynecology Associates, Atlanta, GA 30005, USA. moorer33@hotmail.com
authors.forename: Robert D
authors.initials: RD
authors.lastname: Moore
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ridder
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kennelly
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D009765:Obesity / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D053825:Suburethral Slings / Q000009:adverse effects / Q000706:statistics & numerical data*; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000601:surgery*