title: Objective efficacy of the tension-free vaginal tape in obese/morbidly obese women versus non-obese women, at median five year follow up.
abstract: BACKGROUND
  One subjective long-term evaluation of the tension-free vaginal tape (TVT) success rate in obese women showed a worse prognosis in the obese, but objective studies have been limited to short-term follow-up (less than two years).
  
  
  OBJECTIVE
  To determine whether the long-term objective cure rate in obese/morbidly obese women who underwent TVT was reduced, compared to non-obese women (at five or more years).
  
  
  METHODS
  Body mass index (BMI) was collected on patients undergoing TVT procedure. Recruited patients were asked to perform a 24 h pad test and complete an International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) at five years postoperatively. Data was analyzed according to pre-operative urodynamic diagnoses and BMI, using 'routine' and 'strict' objective definitions of objective cure.
  
  
  RESULTS
  At median follow-up of 64 months (interquartile range 58-80 months), 136 patients returned a pad test and ICIQ-SF. Using a routine definition of cure (pad test of ≤10 g in a 24 h period), 96% of patients were cured overall. The BMI results (n = 119 patients) were stratified into ≤25, 25.1-35 and ≥35.1 kg/m2, which represented 41, 53 and 6% of patients, respectively. The routine cure rates for these three groups were 98, 97 and 71%, respectively (P = 0.004).
  
  
  CONCLUSIONS
  Long-term objective outcomes of the TVT in morbidly obese women are significantly poorer than in women with a normal BMI.
authors.affiliation: The Pelvic Floor Unit, St George Hospital, Sydney, New South Wales, Australia.
authors.forename: Joanne B
authors.initials: JB
authors.lastname: McKenna
authors.affiliation: The Pelvic Floor Unit, St George Hospital, Sydney, New South Wales, Australia.
authors.forename: Katrina
authors.initials: K
authors.lastname: Parkin
authors.affiliation: Department of Urogynaecology, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Ying
authors.identifier: http://orcid.org/0000-0002-2084-7159
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: The Pelvic Floor Unit, St George Hospital, Sydney, New South Wales, Australia.|Department of Urogynaecology, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Kate H
authors.initials: KH
authors.lastname: Moore
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016496:Incontinence Pads; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications* / Q000601:surgery*
keywords: Long-term follow up; morbid obesity; obesity; stress urinary incontinence; tension-free vaginal tape