Comparison of subjective long-term follow-up after mid-urethral sling in obese and non-obese patients.

Objective: Obesity is a key factor for stress urinary incontinence. Our aim was to evaluate the long-term, subjective surgical satisfaction rate among obese (BMI ≥ 30) women after mid-urethral sling (MUS) procedure in a tertiary-level university hospital.

Study Design: This retrospective, case-control study compared the outcomes of obese and non-obese patients who underwent MUS surgery for stress urinary incontinence (SUI), March 2014-January 2020. Patients were followed-up using Urogenital Distress Inventory-6 (UDI-6) and Patient Global Impression of Improvement (PGI-I) telephone questionnaires.

Results: Among 264 patients who had MUS surgery, 107 (40.6%) patients with BMI ≥ 30 kg/m were matched with 157 (59.4%) non-obese patients (BMI < 30 kg/m). Mean follow-up was 41.4 (8-73) months. Obese women had higher post-operative urinary symptom scores in UDI-6 (32.3 vs. 25.7, p =.015) and PGI-I questionnaires (2.9 ± 1.7 vs. 2.3 ± 1.7, p =.03). More patients in the obese group (p =.03) had urinary stress symptoms. Subjective failures (PGI-I ≥ 4) totaled 46 (17.4%), 18 in obese and 28 in non-obese patients, giving cure rates of 83.2% and 82.2%, respectively (p = 1).

Conclusion: Although obese patients had higher UDI-6 scores, an interpretation of this score did not show an increase in distress due to urinary incontinence symptoms (>33.33 points).