title: Do severe obese patients with stress urinary incontinence benefit from transobturator tape procedure? 3-year surgical outcome.
abstract: BACKGROUND
  We evaluate the impact of severe obesity on surgical outcomes of the transobturator tape (TOT) procedure in patients with stress urinary incontinence (SUI).
  
  
  METHODS
  In total, 32 women with severe obesity (body mass index [BMI] >35 kg/m(2)) were included in the study. All patients were preoperatively evaluated with history, pelvic examination, ultrasonography, and cough stress test. All patients completed the International Consultation on Incontinence Questionnaire-Short form (ICIQ-SF) preoperatively and at the postoperative follow-up. Cure of incontinence was defined as being completely dry after surgery. Cure was assessed subjectively and objectively. Subjective improvement defined as an International Consultation on Incontinence Questionnaire-Short form (ICIQ-SF) score ≤12 and satisfaction with surgery. Failure was defined as having no change or worsening of urinary incontinence after surgery. Postoperative patient satisfaction was assessed using a visual analog scale.
  
  
  RESULTS
  The mean follow-up time and mean BMI were 40.9 ± 20.9 months and 38 ± 3 kg/m(2), respectively. According to preoperative ICIQ-SF questionnaire scores, 20 patients (62.5%) had severe and 12 patients (37.5 %) had very severe urinary incontinence symptoms. No patient had slight or moderate symptoms. None of the patients experienced worsening symptoms after surgery. Objective cure, subjective cure, subjective improvement and patient satisfaction rates were 81.2%, 46.8%, 37.5%, and 84.3% respectively. Our overall complication rate was 9.3%. None of the patients experienced intraoperative complications.
  
  
  CONCLUSIONS
  In experienced hands, TOT is an effective and safe procedure to treat SUI, with minimal complications in severe obese women.
authors.affiliation: Izmir Bozyaka Training and Research Hospital, Urology Clinic, Turkey.
authors.forename: Tarik
authors.initials: T
authors.lastname: Yonguc
authors.affiliation: Izmir Bozyaka Training and Research Hospital, Urology Clinic, Turkey.
authors.forename: Ozgu
authors.initials: O
authors.lastname: Aydogdu
authors.affiliation: Izmir Bozyaka Training and Research Hospital, Urology Clinic, Turkey.
authors.forename: Ibrahim Halil
authors.initials: IH
authors.lastname: Bozkurt
authors.affiliation: Izmir Bozyaka Training and Research Hospital, Urology Clinic, Turkey.
authors.forename: Tansu
authors.initials: T
authors.lastname: Degirmenci
authors.affiliation: Izmir Bozyaka Training and Research Hospital, Urology Clinic, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Gunlusoy
authors.affiliation: Izmir Bozyaka Training and Research Hospital, Urology Clinic, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Sen
authors.affiliation: Izmir Bozyaka Training and Research Hospital, Urology Clinic, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Yarimoglu