%0 Journal Article
%T Obesity and the Incidence of Bladder Injury and Urinary Retention Following Tension-Free Vaginal Tape Procedure: Retrospective Cohort Study
%A Vladimir Revicky
%A Sambit Mukhopadhyay
%A Frances de Boer
%A Edward P. Morris
%J Obstetrics and Gynecology International
%D 2011
%I Hindawi Publishing Corporation
%R 10.1155/2011/746393
%X Background/Aims. Aim of the study was to establish an effect of obesity on the incidence of bladder injury or urinary retention following tension-free vaginal tape (TVT) procedure. Methods. This was a retrospective cohort study based at the Norfolk and Norwich University Hospital in the UK. Study population included 342 cases of TVT procedures. Incidence of bladder injury was 4.7% (16/342). Rate of urinary retention was 9% (31/342). Body mass index (BMI), age, type of analgesia, concomitant prolapse repair, and previous surgery were factors studied. Univariate analysis was performed to establish a relationship between BMI and complications, followed by a multivariable regression analysis to adjust for age, concomitant surgery, type of analgesia, and previous surgery. Results. Neither univariate analysis nor multivariate regression analysis revealed any statistically significant influence of obesity on the incidence of bladder injury or urinary retention. Unadjusted odds ratios and adjusted odds ratios for bladder injury and urinary retention by BMI groups were OR 1.7296 CI 0.4818每6.2097; OR 1.3745 CI 0.5718每3.3043 and adj. OR 2.885 CI 0.603每13.8; adj. OR 1.299 CI 0.502每3.365. Conclusion. Obesity does not appear to influence the rate of bladder injury or urinary retention following TVT procedure. 1. Introduction An involuntary urine leakage on effort or exertion or on sneezing or coughing without increase in detrusor pressure is defined as stress urinary incontinence (SUI) [1]. The prevalence of SUI in nulliparous women is estimated to 4.7%, age-standardized prevalence in women with history of Caesarean section is 6.9% and with history of vaginal delivery is 12.2% [2]. However, some reports estimated that SUI may be affecting up to 30% of women [3]. Pathophysiology of SUI was explained by hypermobility of the urethra and bladder neck during exertion [4]. Provided, surgical treatment for SUI is considered, retropubic mid-urethral tape procedure using a ※bottom-up§ approach with macroporous polypropylene meshes is recommended [5]. In 1996, tension-free vaginal tape (TVT) procedure was described for the first time and it quickly became one of the most popular procedures worldwide [6, 7]. Although TVT is considered minimally invasive, it carries risk of immediate surgical complications as bladder injury and injury to pelvic vessels and bowel [8每10]. Further, urge incontinence and voiding dysfunction are recognised postoperative complications [8, 10]. Currently, there is conflicting evidence on the effect of obesity on peri- and postoperative complications in
%U http://www.hindawi.com/journals/ogi/2011/746393/