Comparison of Long-Term Outcomes of Transobturator Rectus Fascia Sling and Polypropylene Mesh in Obese Women?

Abstract

Objective:

This study compared the long-term outcomes of polypropylene mesh (PPM) and transobturator rectus fascia (RF) slings in transobturator tape (TOT) surgery in obese women.

Materials and Methods:

Data were analyzed retrospectively of patients who underwent TOT surgery between May 2012 and November 2018, with a diagnosis of pure stress urinary incontinence or stress-predominant mixed urinary incontinence,. Patients whose body mass indices were >30kg/m² were divided into 2 groups: PPM and RF, according to the sling materials used. The patients were compared in terms of clinical data and surgical outcomes.

Results:

There were 133 (82.09%) in the PPM group and 29 (17.91%) in the RF group. The mean age in the PPM group was 53.74 ± 10.15 years, and the mean age in the RF group was 48.69 ± 7.22 years. The decrease in the number of pads used daily in both groups was similar (p = 0.560). Mean operation time, hospitalization time, and visual analogue scale score were higher in the RF group than in the PPM group (p < 0.001, p < 0.001, and p < 0.001, respectively). There was no significant difference between the groups in terms of postoperative ıncontinence quality of life questionnaire scores (p = 0.705), improvement in International Consultation on Incontinence Questionnaire—Short Form scores (p = 0.242), improvement in number of pads used daily (p = 0.292), and complications (p = 0.908).

Conclusions:

TOT surgery can be performed safely and effectively with PPM or RF as a sling material for treating stress incontinence in obese women. However, the transobturator RF sling prolongs operation and hospitalization times significantly. (J GYNECOL SURG 37:246)