Does obesity affect the outcome of vaginal sling procedures?

This study investigated whether obesity affects the outcome of vaginal sling procedures. Researchers concluded that vaginal sling procedures are as safe and effective in treating urinary incontinence in obese women as they are in non-obese women. 

Vaginal sling procedures are currently the most common type of surgery used to help control stress urinary incontinence. Some studies have recently suggested that obese women do not respond to, or tolerate, vaginal slings as well as women within a normal weight range. However, evidence to this effect is mixed, with some studies reporting no effect of obesity on the outcome of vaginal sling procedures. Larger high-quality studies are needed to establish the long-term effects and safety of vaginal sling procedures in treating urinary incontinence among obese women.

This study included 281 women that had undergone a vaginal sling procedure for the treatment of stress urinary incontinence. Of these, 122 women were classified as obese. Treatment outcome was compared between obese women (with a body-mass-index equal to or greater than 30) and non-obese women (with a body-mass-index of less than 30), over the course of four years.

Analysis showed no significant differences in treatment outcomes between obese women and non-obese women. Self-reported incontinence symptoms, pelvic examinations, stress incontinence tests, as well as quality of life scores, were all similarly improved. Four years after the vaginal sling procedure, 95% of obese women and 96% of non-obese women achieved continence (no urine leakage during stress test).

Complications such as damage to the local tissue during the procedure, urinary retention (a temporary inability to pass urine), or urinary urgency were noted with similar rates among obese women (7% reported complications) and non-obese women (4% reported complications). The erosion rate of the vaginal slings during the study follow-up was noted to be only 1%.

Researchers concluded that vaginal sling procedures are a safe and effective long-term treatment option for stress urinary incontinence regardless of weight.

Due to the high drop-out rate in (about 40%) in this study, larger randomized trials are needed to confirm these findings.