title: Efficacy and perioperative safety of synthetic mid-urethral slings in obese women with stress urinary incontinence.
abstract: OBJECTIVE
  Obesity is associated with an increased prevalence of female stress urinary incontinence (SUI). Mid-urethral polypropylene sling is considered the surgical gold standard for treatment of SUI. We reviewed the current literature on efficacy at 1 year (or more) and perioperative safety of synthetic mid-urethral sling procedures for SUI in obese women.
  
  
  METHODS
  A systematic search of PubMed, Embase and the Cochrane databases was performed using the MeSH terms "Stress urinary incontinence", "Overweight", "Obesity" and "Surgery". We included 13 full-text papers published from January 1995 to May 2014. We defined two groups of women: non-obese (BMI below 30 kg/m(2)) and obese (BMI above 30 kg/m(2)). Data regarding subjective and objective cure and selected perioperative complications were pooled and compared.
  
  
  RESULTS
  The pooled data from the 13 studies showed that 76.4% and 74.7% of non-obese and obese women, respectively, were subjectively cured (p = 0.70), and 83.3% and 79.2%, respectively, were objectively cured (p = 0.56). Bladder perforation was more frequently reported in non-obese women (p <  0.01). We did not detect a significant difference in postoperative urine retention or sling excision between the two groups (p = 0.36 and p = 0.17, respectively).
  
  
  CONCLUSIONS
  Cure rates were found to be comparable in obese and non-obese women. Perioperative complications were not reported to occur more often in obese women. The outcomes of sling procedures for SUI appear to be comparable in obese and non-obese women, and counselling of obese women regarding outcomes and perioperative complications can be similar.
authors.affiliation: Department of Obstetrics and Gynecology, Herlev University Hospital, Herlev, Denmark, vweltz@mailme.dk.
authors.forename: V
authors.initials: V
authors.lastname: Weltz
authors.forename: R
authors.initials: R
authors.lastname: Guldberg
authors.forename: G
authors.initials: G
authors.lastname: Lose
mesh_terms: D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications*; D059035:Perioperative Period; D011183:Postoperative Complications / Q000209:etiology*; D053825:Suburethral Slings / Q000009:adverse effects*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications* / Q000601:surgery*