Abstract: PD50-02
Sources of Funding: none

Introduction

Obesity has been associated with urinary incontinence and may worsen incontinence related complaints following robotic sacral colpopexy (RSC). Elevated Body Mass Index (BMI) may confer an increased risk of denovo stress urinary incontinence (SUI) even when mid urethral sling (MUS) is performed. We sought to determine the risk of denovo stress incontinence following robotic sacral colpopexy in patients with elevated BMI and assess the impact of BMI on postoperative Quality of Life (QoL) metrics.

Methods

Retrospective chart review was undertaken and continence and BMI are noted. BMI was stratified according to the NIH classification. Outcomes were patient reported SUI and pad use, development of denovo SUI after colpopexy, and decision to undergo MUS after RSC. Incontinence was defined as any mention of SUI at any one of the follow up visits when asked directly by the examiner, SUI in the bladder diary, or evidence of SUI on the supine stress test.

Results

Between 2009 and 2015 134 women underwent RSC. 52 patients complained of urinary incontinence pre operatively (38.5%). As BMI increased, the number of pads recorded on preoperative bladder diary also increased, however, following concomitant mid urethral sling there was no difference in number of patients reporting incontinence or pad use at the last postoperative visit (Table 1) over 21.3 months follow up. The denovo rate of urinary incontinence did not increase as the BMI increased and failed to meet statistical significance, with normal BMI having a de?novo SUI rate of 26%, overweight 17%, obese 23%, and extreme obesity 25%, p>0.05.

Conclusions

Obese patients undergoing RSC have increased preoperative pad use and SUI rates but have similar SUI cure rates and denovo SUI rates compared with nonobese patients.

Funding

none