Obesity – Risk Factor in theSurgical Treatment of Urinary Stress Incotinence by BurchColposuspension?

Overview

Objective:
The evaluation of the success rate after the Burch colposuspension in obese and nonobese patients with genuine stress incontinence.Design: Prospective clinical trial.Setting: Obstetrics and Gynaecology Department, Charles University 2ndMedical School and Faculty Hospital Motol, Prague.Methods: A group of 26 obese and 56 non obese patients who underwent Burch colposuspension in1997 and 1998 were studied. Preoperative and postoperative examination consisted of clinicalhistory, physical examination, BMI, urodynamic evaluation, Q-tip test, stress test, age, menopausal status, duration of incontinence before surgery, lenght of follow-up, symptoms of urgencyafter surgery, postoperative complications and restoration of the micturition after procedure.Both objective parameters and subjective assessment were included in the postoperative evaluati-on of surgical treatment. c2test, Mantel-Haenszel version was used for statistical analysis andexact Fisher test for low-frequency-cases in table enclosed. Computation was realised by SystemEPIINFO version 6.Results: The continence rate after intermediate follow-up in the group of 26 obese patients was84,6% and the success rate in the group of 56 non obese was 87,5%. The difference between theresults of both groups were not statistically significant. The operations were somewhat moredifficult to perform due to the body habitus of the obese patients but there were no intraoperativecomplications and only 1 patient had serious wound infection postoperatively.Conclusions: Obese women with stress urinary incontinence can undergo Burch colposuspensionwith a good chance of success. Statistically important differences in mid-term follow-up of treatment successfulness of obese and non obese women have not been demonstrated. We recommendcomplete evaluation to ensure proper classification of the urinary incontinence. Burch colposuspension performed by experienced surgeon is a safe and efficacious procedure in the surgicaltreatment of obese patients with genuine stress incontinence.

Key words:
Burch colposuspension, genuine stress incontinence, obesity, BMI, unsuccesful treat-ment, Intermediate follow-up