nach oben

International Urogynecology Journal

Erschienen in:

08.08.2019 | Original Article

Obesity and its long-term impact on sacrocolpopexy key outcomes (OBELISK)

verfasst von: Martin Smazinka, Vladimir Kalis, Martin Havir, Linda Havelkova, Khaled M. Ismail, Zdenek Rusavy

Erschienen in: International Urogynecology Journal | Ausgabe 8/2020

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

Sacrocolpopexy is the preferred contemporary approach to managing significant apical pelvic organ prolapse. Obesity is an established risk factor for several surgical procedures and can have a negative impact on outcomes. Our goal was to evaluate the impact of BMI on the safety and efficacy of laparoscopic sacrocolpopexy in women with pelvic organ prolapse.

Methods

A single-center retrospective observational study of women undergoing laparoscopic sacrocolpopexy between January 1, 2015, and December 31, 2017.

Results

We found 299 procedures: 82 (27.4%), 147 (49.2%) and 70 (23.4%) in women with BMI <25 (normal weight), BMI ≥ 25 – < 30 (overweight) and BMI ≥ 30 (obese), respectively. Perioperative and early postoperative complications were generally low and not statistically significantly different between the groups. At 12 months postoperatively, 81 (98.8%), 136 (92.5%) and 62 (88.6%) normal-weight, overweight and obese women attended their follow-up, respectively. All obese women attending the follow-up scored an overall Patient Global Impression of Improvement (PGI-I) of ≤ 3. The Pelvic Floor Distress Inventory (PFDI) scores showed a significant improvement in all domains and were similar between the study groups. In total, there was one (0.4%) anatomical apical compartment failure, three (1.1%) anterior compartment failures and two (0.7%) posterior compartment failures with no significant differences between the groups. Similarly, there were no differences in functional outcomes or mesh position as assessed by ultrasound.

Conclusions

There were no differences in surgical, short- and long-term outcomes of laparoscopic sacrocolpopexy for pelvic organ prolapse in obese compared with non-obese women.

Nur mit Berechtigung zugänglich

Engin A. (2017) The definition and prevalence of obesity and metabolic syndrome. In: Engin A., Engin A. (eds) Obesity and lipotoxicity. Adv Exp Med Biol, vol 960. Springer, Cham

Vidra N, Bijlsma MJ, Trias-Llimós S, Janssen F. Past trends in obesity-attributable mortality in eight European countries: an application of age–period–cohort analysis. Int J Public Health. 2018. https://doi.org/10.1007/s00038-018-1126-2.

Bradley CS, Kenton KS, Richter HE, et al. Obesity and outcomes after sacrocolpopexy. Am J Obstet Gynecol. 2008;199:690.e1–8. https://doi.org/10.1016/j.ajog.2008.07.030.CrossRef

Halder GE, Salemi JL, Hart S, Mikhail E. Association between obesity and perioperative morbidity in open versus laparoscopic sacrocolpopexy. Female Pelvic Med Reconstr Surg. 2017;23:146–50. https://doi.org/10.1097/SPV.0000000000000382.CrossRefPubMed

Haylen BT, Maher CF, Barber MD, et al. Erratum to: an International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J. 2016;27:655–84. https://doi.org/10.1007/s00192-016-3003-y.CrossRefPubMed

Weber AM, Abrams P, Brubaker L, et al. The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12:178–86. https://doi.org/10.1007/PL00004033.CrossRefPubMedPubMedCentral

Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24:1783–90. https://doi.org/10.1007/s00192-013-2169-9.CrossRefPubMed

Augusto KL, Bezerra LRPS, Murad-Regadas SM, et al. Defecatory dysfunction and fecal incontinence in women with or without posterior vaginal wall prolapse as measured by pelvic organ prolapse quantification (POP-Q). Eur J Obstet Gynecol Reprod Biol. 2017;214:50–5. https://doi.org/10.1016/j.ejogrb.2017.04.039.CrossRefPubMed

Giri A, Hartmann KE, Hellwege JN, et al. Obesity and pelvic organ prolapse: a systematic review and meta-analysis of observational studies. Am J Obstet Gynecol. 2017;217:11–26.e3. https://doi.org/10.1016/j.ajog.2017.01.039.CrossRefPubMed

10.

Dieter AA, Edenfield AL, Weidner AC, Siddiqui NY. How does site of pelvic organ prolapse repair affect overactive bladder symptoms? Female Pelvic Med Reconstr Surg. 2014;20:203–7. https://doi.org/10.1097/SPV.0000000000000087.CrossRefPubMed

11.

Lowenstein L, Gamble T, Deniseiko Sanses TV, et al. Sexual function is related to body image perception in women with pelvic organ prolapse. J Sex Med. 2009;6:2286–91. https://doi.org/10.1111/j.1743-6109.2009.01329.x.CrossRefPubMed

12.

Espuña-Pons M, Fillol M, Pascual MA, et al. Pelvic floor symptoms and severity of pelvic organ prolapse in women seeking care for pelvic floor problems. Eur J Obstet Gynecol Reprod Biol. 2014;177:141–5. https://doi.org/10.1016/j.ejogrb.2014.03.050.CrossRefPubMed

13.

Bilgic D, Gokyildiz S, Kizilkaya Beji N, et al. Quality of life and sexual functıon in obese women with pelvic floor dysfunction. Women Health. 2019;59:101–13. https://doi.org/10.1080/03630242.2018.1492497.CrossRefPubMed

14.

Whitcomb EL, Lukacz ES, Lawrence JM, et al. Prevalence and degree of bother from pelvic floor disorders in obese women. Int Urogynecol J. 2009;20:289–94. https://doi.org/10.1007/s00192-008-0765-x.CrossRef

15.

Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. In: Maher C, editor. Cochrane database of systematic reviews. Chichester: Wiley; 2013.

16.

Barber MD, Maher C. Apical prolapse. Int Urogynecol J. 2013;24:1815–33. https://doi.org/10.1007/s00192-013-2172-1.CrossRefPubMed

17.

Costantini E, Brubaker L, Cervigni M, et al. Sacrocolpopexy for pelvic organ prolapse: evidence-based review and recommendations. Eur J Obstet Gynecol Reprod Biol. 2016;205:60–5. https://doi.org/10.1016/j.ejogrb.2016.07.503.CrossRefPubMed

18.

De Gouveia De Sa M, Claydon LS, Whitlow B, Dolcet Artahona MA. Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis. Int Urogynecol J. 2016;27:3–17. https://doi.org/10.1007/s00192-015-2765-y.CrossRefPubMed

19.

Barber MD, Kuchibhatla MN, Pieper CF, Bump RC. Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol. 2001;185:1388–95. https://doi.org/10.1067/mob.2001.118659.CrossRefPubMed

20.

Srikrishna S, Robinson D, Cardozo L. Validation of the patient global impression of improvement (PGI-I) for urogenital prolapse. Int Urogynecol J. 2010;21:523–8. https://doi.org/10.1007/s00192-009-1069-5.CrossRefPubMed

21.

Haylen BT, Freeman RM, Swift SE, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Int Urogynecol J. 2011;22:3–15. https://doi.org/10.1007/s00192-010-1324-9.CrossRefPubMed

22.

Gutman RE, Rardin CR, Sokol ER, et al. Vaginal and laparoscopic mesh hysteropexy for uterovaginal prolapse: a parallel cohort study. Am J Obstet Gynecol 2017;216:38.e1–11.

23.

Dietz HP, Haylen BT, Broome J. Ultrasound in the quantification of female pelvic organ prolapse. Ultrasound Obstet Gynecol. 2001;18:511–4. https://doi.org/10.1046/j.0960-7692.2001.00494.x.CrossRefPubMed

24.

Wong V, Guzman Rojas R, Shek KL, et al. Laparoscopic sacrocolpopexy: how low does the mesh go? Ultrasound Obstet Gynecol. 2017;49:404–8. https://doi.org/10.1002/uog.15882.CrossRefPubMed

25.

Svabík K, Martan A, Masata J, et al. Ultrasound appearances after mesh implantation—evidence of mesh contraction or folding? Int Urogynecol J. 2011;22:529–33. https://doi.org/10.1007/s00192-010-1308-9.CrossRefPubMed

26.

Dindo D, Demartines N, Clavien P-A. Classification of surgical complications. Ann Surg. 2004;240:205–13. https://doi.org/10.1097/01.sla.0000133083.54934.ae.CrossRefPubMedPubMedCentral

27.

Turner L, Lavelle E, Lowder JL, Shepherd JP. The impact of obesity on intraoperative complications and prolapse recurrence after minimally invasive sacrocolpopexy. Female Pelvic Med Reconstr Surg. 2016;22:317–23. https://doi.org/10.1097/SPV.0000000000000278.CrossRefPubMed

28.

Thubert T, Naveau A, Letohic A, et al. Outcomes and feasibility of laparoscopic sacrocolpopexy among obese versus non-obese women. Int J Gynecol Obstet. 2013;120:49–52. https://doi.org/10.1016/j.ijgo.2012.07.020.CrossRef

29.

Mahoney C, Scott G, Dwyer L, et al. Laparoscopic sacrocolpopexy posthysterectomy: intraoperative feasibility and safety in obese women compared with women of normal weight. Int Urogynecol J. 2019. https://doi.org/10.1007/s00192-019-03888-y.

Titel: Obesity and its long-term impact on sacrocolpopexy key outcomes (OBELISK)
verfasst von: Martin Smazinka
Vladimir Kalis
Martin Havir
Linda Havelkova
Khaled M. Ismail
Zdenek Rusavy
Publikationsdatum: 08.08.2019
Verlag: Springer International Publishing
Erschienen in: International Urogynecology Journal / Ausgabe 8/2020
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-019-04076-8

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Alter der Mutter beeinflusst Risiko für kongenitale Anomalie

28.05.2024 Kinder- und Jugendgynäkologie Nachrichten

Welchen Einfluss das Alter ihrer Mutter auf das Risiko hat, dass Kinder mit nicht chromosomal bedingter Malformation zur Welt kommen, hat eine ungarische Studie untersucht. Sie zeigt: Nicht nur fortgeschrittenes Alter ist riskant.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Obesity and its long-term impact on sacrocolpopexy key outcomes (OBELISK)

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Alter der Mutter beeinflusst Risiko für kongenitale Anomalie

Fehlerkultur in der Medizin – Offenheit zählt!

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

Update Gynäkologie

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2020

Pelvic organ prolapse repair with a trocarless mesh system: two-year results

Effectiveness of hormones in postmenopausal pelvic floor dysfunction—International Urogynecology Association research and development—committee opinion

The safety and efficacy of CO2 laser in the treatment of stress urinary incontinence

Severity of urinary incontinence is associated with prevalence of sexual dysfunction

Abstracts Presented at the Annual Research meeting of the British Society of Urogynaecology (BSUG), London. October 2019

Catherine Hamlin 1924–2020

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Alter der Mutter beeinflusst Risiko für kongenitale Anomalie

Fehlerkultur in der Medizin – Offenheit zählt!

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

Update Gynäkologie