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Song J, Song X, Wang Z, Alas A. Impact of Obesity on Midurethral Sling Failure in a Highly Hispanic Population. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024:02273501-990000000-00220. [PMID: 38710010 DOI: 10.1097/spv.0000000000001523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
IMPORTANCE Mixed data exist in the literature regarding the impact of obesity on midurethral sling (MUS) failure rates. OBJECTIVE The aim of this study was to evaluate the impact of obesity and Hispanic ethnicity on MUS failure. STUDY DESIGN This was a retrospective cohort study of females who underwent MUS surgery, alone or with concomitant prolapse repair, with at least 1 year of follow-up. Body mass index (BMI) classes were categorized as normal (<25 kg/m2), overweight (25-29.9 kg/m2), obese (30-39.9 kg/m2), and severe obesity (≥40 kg/m2). The primary outcome was MUS failure, defined as a composite of subjectively unchanged or worsened symptoms or need for additional procedures. Secondary outcomes included risk factors related to MUS failure and the effect of ethnicity on MUS failure rates. RESULTS A total of 322 women were included for analysis. The mean age was 52.3 years. Increasing BMI was associated with higher MUS failure, with multivariate logistic regression showing a 5% increased risk for each 1 kg/m2 BMI increase. Failure rates were significantly different between normal BMI and severe obesity (16.7% vs 36.4%, P = 0.04). After adjusting for other variables, transobturator slings had a higher risk of failure compared with retropubic slings, whereas surgeon training and patient ethnicity did not affect failure rates. CONCLUSIONS We found that increasing BMI was associated with higher MUS failures, with significantly higher failure rates in the severely obese population. Although MUS remains the standard of care for treatment of SUI, based on our findings, counseling should be individualized to the patient, taking into account each patient's unique characteristics.
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Affiliation(s)
- Jun Song
- From the Joe R. Teresa Lozano Long School of Medicine, UT Health San Antonio, San Antonio, TX
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Daykan Y, Klein Z, Eliner O, O'Reilly BA, Yagur Y, Belkin S, Ribak R, Arbib N, Schonman R. Can obesity impact mesh exposure rate after mid-urethral sling operation? Medium term follow-up. Eur J Obstet Gynecol Reprod Biol 2023; 280:98-101. [PMID: 36442380 DOI: 10.1016/j.ejogrb.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/10/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To study mesh exposure rates among obese (BMI ≥ 30 kg/m2) vs non-obese women after mid-urethral sling (MUS) operation. STUDY DESIGN This retrospective cohort study included all patients who underwent MUS surgery for stress urinary incontinence April 2014-April 2021 in a tertiary-level university hospital. Data from obese and non-obese patients were compared. RESULTS A total of 120 (41 %) obese patients and 172 (59 %) non-obese patients who had mid-urethral sling surgery were compared. Of the cohort, 265 (90.7 %) underwent TVT-obturator, 15 (5.1 %) mini-sling TVT, and 12 (4.1 %) retro-pubic TVT. Diabetes mellitus was significantly more prevalent in the obese group (p =.01), without other demographic differences. Mesh post-operative exposure rate was 5.4 % during the study. The obese group had lower incidence of mesh exposure than the non-obese group (1.6 % vs 8.1 % respectively, p =.018). Mean follow-up was 51 months (range 8-87 months) without significant differences between groups (49.9 ± 21.2 vs 51.5 ± 22.3, p =.548). Pelvic organ prolapse, cystocele, and rectocele stages were significantly higher in non-obese patients. Similar numbers of post-menopausal women were in each group. CONCLUSION This follow-up after MUS surgery showed an association between obesity and lower rate of mesh exposure. Further research is needed to evaluate correlations between estrogen and mesh exposure.
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Affiliation(s)
- Yair Daykan
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Urogynaecology, Cork University Maternity Hospital, Cork, Ireland.
| | - Zvi Klein
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Or Eliner
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Barry A O'Reilly
- Department of Urogynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Yael Yagur
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shir Belkin
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rachel Ribak
- Department of Obstetrics and Gynecology, HaEmek Medical Center, Afula, Israel. Affiliated to Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Nissim Arbib
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Schonman
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Schiavi MC, Carletti V, Yacoub V, Cardella G, Luffarelli P, Valensise HCC, Palazzetti P, Spina V, Zullo MA. Evaluation of the efficacy and safety of single incision sling vs TVT-O in obese patients with stress urinary incontinence: Quality of life and sexual function analysis. Taiwan J Obstet Gynecol 2023; 62:89-93. [PMID: 36720557 DOI: 10.1016/j.tjog.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES The aim of the study is to demonstrate the best stress urinary incontinence (SUI) surgical technique for women with a Body mass index higher than 30. The results of Transvaginal Tension Free Vaginal Tape-Obturator and Mini-sling surgery were analyzed and compared through both clinical examination and standardized questionnaires at 36 months of follow-up. MATERIALS AND METHODS This is a retrospective multicenter study over 159 women with SUI who underwent surgery. Seventy-eight women underwent TVT-O and 81 Mini-sling technique. Intra and post-operative complications were recorded. Patients were monitored for 36 months by analyzing symptoms, voiding diary, quality of life and sexual activity through standardized questionnaires. RESULTS Complications had a low incidence in both groups and inter-group differences were superimposable. Only groin pain was statistically higher after TVT-O than after Mini-sling (12.8% vs1.2%, p = 0.03). At 36 months of follow-up, a statistically significant decrease in Positive stress test (%) and Q-Tip test (grade) was observed in both groups with no differences between them (p = 0.54 and p = 0.32 respectively). The mean number of daily voids was higher after TVT-O (p = 0.04) than after Altis (p = 0.22) with a significant difference in favor of the Altis group (p = 0.03). After 36 months, there were no significant differences between groups in terms of quality of life and sexual activity. PGI-I did not show any difference between groups (p = 0.21). CONCLUSION TVT-O and Minisling had the same efficacy and results in the surgical treatment of SUI in obese women. Both techniques relieved their symptoms and improved their quality of life without any significant difference except for a lower incidence of post- Mini-sling complications.
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Affiliation(s)
| | - Valerio Carletti
- Department of Obstetrics and Gynecology, "Tor Vergata" University, Rome, Italy.
| | - Veronica Yacoub
- Department of Obstetrics and Gynecology, "Tor Vergata" University, Rome, Italy
| | - Giorgia Cardella
- Department of Obstetrics and Gynecology, "Tor Vergata" University, Rome, Italy
| | - Paolo Luffarelli
- Department of Pelvic Floor Surgery and Proctology, "Campus Biomedico" University, Rome, Italy
| | - Herbert Carmelo Carlo Valensise
- Department of Obstetrics and Gynecology, "Tor Vergata" University, Rome, Italy; Department of Obstetrics and Gynecology, "Casilino" Hospital, Rome, Italy
| | | | - Vincenzo Spina
- UOC Maternal and Child Health Protection, ASL Rieti, Italy
| | - Marzio Angelo Zullo
- Department of Pelvic Floor Surgery and Proctology, "Campus Biomedico" University, Rome, Italy
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Comparison of subjective long-term follow-up after mid-urethral sling in obese and non-obese patients. Eur J Obstet Gynecol Reprod Biol 2022; 273:86-89. [PMID: 35525131 DOI: 10.1016/j.ejogrb.2022.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Obesity is a key factor for stress urinary incontinence. Our aim was to evaluate the long-term, subjective surgical satisfaction rate among obese (BMI ≥ 30) women after mid-urethral sling (MUS) procedure in a tertiary-level university hospital. STUDY DESIGN This retrospective, case-control study compared the outcomes of obese and non-obese patients who underwent MUS surgery for stress urinary incontinence (SUI), March 2014-January 2020. Patients were followed-up using Urogenital Distress Inventory-6 (UDI-6) and Patient Global Impression of Improvement (PGI-I) telephone questionnaires. RESULTS Among 264 patients who had MUS surgery, 107 (40.6%) patients with BMI ≥ 30 kg/m2 were matched with 157 (59.4%) non-obese patients (BMI < 30 kg/m2). Mean follow-up was 41.4 (8-73) months. Obese women had higher post-operative urinary symptom scores in UDI-6 (32.3 vs. 25.7, p =.015) and PGI-I questionnaires (2.9 ± 1.7 vs. 2.3 ± 1.7, p =.03). More patients in the obese group (p =.03) had urinary stress symptoms. Subjective failures (PGI-I ≥ 4) totaled 46 (17.4%), 18 in obese and 28 in non-obese patients, giving cure rates of 83.2% and 82.2%, respectively (p = 1). CONCLUSION Although obese patients had higher UDI-6 scores, an interpretation of this score did not show an increase in distress due to urinary incontinence symptoms (>33.33 points).
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Doumouchtsis SK, Loganathan J, Pergialiotis V. The Role of Obesity on Urinary and Anal Incontinence in women: a review. BJOG 2021; 129:162-170. [PMID: 34312978 DOI: 10.1111/1471-0528.16848] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 11/30/2022]
Abstract
Obesity is increasing worldwide with significant healthcare implications. We searched PubMed/MEDLINE, Embase and Cochrane Library for articles registered until June 2020 to explore the relationship between obesity, urinary (UI) and anal incontinence (AI). Obesity is associated with low-grade, systemic inflammation and pro-inflammatory cytokine release, producing reactive oxygen species and oxidative stress (1). This alters collagen metabolism and, in combination with increased intraabdominal pressure, contributes to UI development. Whereas in AI, stool consistency may be a factor. Weight loss can reduce UI and should be a management focus, however effect on AI is less clear. Keywords: Obesity, Urinary incontinence, Anal incontinence.
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Affiliation(s)
- Stergios K Doumouchtsis
- Epsom and Saint, Helier University Hospitals NHS Trust, Obstetrics and Gynaecology, Surrey, UK
| | - Jemina Loganathan
- Epsom and Saint, Helier University Hospitals NHS Trust, Obstetrics and Gynaecology, Surrey, UK
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Hsiao SM, Kuo HC. Predictors of further anti-incontinence interventions or transvaginal urethrolysis after a pubovaginal sling procedure in women with and without neurologic disorders. J Formos Med Assoc 2021; 120:1464-1477. [PMID: 33468403 DOI: 10.1016/j.jfma.2020.12.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/13/2020] [Accepted: 12/31/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/PURPOSE The impact of neurologic disorders on the clinical outcome of suburethral sling procedures has seldom been studied. Our aim is to elucidate factors predicting further anti-incontinence interventions or transvaginal urethrolysis after a re-adjustable pubovaginal sling procedure (PVS), especially in patients with neurologic disorders. METHODS Medical records of all consecutive women who underwent re-adjustable PVS for stress urinary incontinence (SUI) were reviewed. RESULTS A total of 589 women were enrolled, 152 (25.8%) women were found to have persistent or recurrent SUI after surgery, and 39 (6.6%) women underwent further anti-incontinence interventions. Postoperative voiding dysfunction was found in 46 (7.8%) women, and 23 women (3.9%) underwent transvaginal urethrolysis. Low body mass index (hazard ratio = 0.92) and low functional bladder capacity (dL, hazard ratio = 0.83) were factors predicting the presence of persistent/recurrent SUI. However, the presence of spinal cord disorder (hazard ratio = 8.91) and a history of prior surgery for pelvic organ prolapse (hazard ratio = 2.51) were factors predicting further anti-incontinence interventions. A high post-void residual volume (PVR, dL, hazard ratio = 1.52) and preoperative bladder outlet obstruction (BOO, hazard ratio = 5.39) were factors predicting postoperative voiding dysfunction. Similarly, a high PVR (dL, hazard ratio = 1.50) and preoperative BOO (hazard ratio = 5.38) were factors predicting transvaginal urethrolysis. A PVR >1.51 dL was an optimal cut-off value for predicting transvaginal urethrolysis. CONCLUSION The presence of spinal cord disorder and prior surgery for pelvic organ prolapse were predictors of further anti-incontinence interventions after re-adjustable PVS. In addition, a large PVR and preoperative BOO were predictors of transvaginal urethrolysis after re-adjustable PVS.
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Affiliation(s)
- Sheng-Mou Hsiao
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
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Barco-Castillo C, Plata M, Zuluaga L, Serrano A, Gómez A, Santander J, Caicedo JI, Azuero J, Echeverry M, Trujillo CG. Obesity as a risk factor for poor outcomes after sling surgery in women with stress urinary incontinence: A systematic review and meta-analysis. Neurourol Urodyn 2020; 39:2153-2160. [PMID: 32794648 DOI: 10.1002/nau.24459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/11/2020] [Accepted: 07/08/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE Obesity is one of the main risk factors for stress urinary incontinence (SUI) and has also been associated with worse surgical outcomes. However, the literature is heterogeneous and inconclusive. The goal of this study was to perform a systematic review and meta-analysis to evaluate cure rates and perioperative complications in obese women. MATERIALS AND METHODS A literature search of OVID, MEDNAR, Embase, Scopus, Web of Science, PubMed, and CENTRAL databases was conducted. Randomized controlled trials comparing cure rates and failure of treatment in normal and obese patients, who underwent mid-urethral sling surgery, were identified. A systematic review of subjective and objective cure rates, and complications was performed. Meta-analyses of dichotomous data under the random-effects model were applied using Review Manager 5.3. Nonrandomized comparative studies and gray literature were excluded. RESULTS A total of 219 studies were identified. Four randomized controlled trials were included for evaluation. The risk of bias evaluation was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. One study was excluded due to missing data on the outcomes. Patients were stratified according to their body mass index as obese (>30 kg/m2 ) and nonobese (<30 kg/m2 ). Complications could not be meta-analyzed. The meta-analysis of subjective (risk ratio [RR] = 1.69 [95% confidence interval [CI]: 1.32-2.16]) and objective (RR = 1.62 [95% CI: 1.26-2.07]) cure rates disfavored obese women. CONCLUSIONS This meta-analysis shows that obesity is a risk factor for the nonsuccessful treatment of SUI with tension-free mid-urethral sling. Differences in regards to the surgical approach and its association with obesity could not be established with the current evidence.
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Affiliation(s)
- Catalina Barco-Castillo
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.,School of Medicine, Universidad de los Andes School of Medicine, Bogotá DC, Colombia
| | - Mauricio Plata
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.,School of Medicine, Universidad de los Andes School of Medicine, Bogotá DC, Colombia
| | - Laura Zuluaga
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.,School of Medicine, Universidad de los Andes School of Medicine, Bogotá DC, Colombia
| | - Adolfo Serrano
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.,School of Medicine, Universidad de los Andes School of Medicine, Bogotá DC, Colombia
| | - Andrea Gómez
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.,School of Medicine, Universidad de los Andes School of Medicine, Bogotá DC, Colombia
| | - Jessica Santander
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.,School of Medicine, Universidad de los Andes School of Medicine, Bogotá DC, Colombia
| | - Juan I Caicedo
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.,School of Medicine, Universidad de los Andes School of Medicine, Bogotá DC, Colombia
| | - Julián Azuero
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.,School of Medicine, Universidad de los Andes School of Medicine, Bogotá DC, Colombia
| | - Mariana Echeverry
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.,School of Medicine, Universidad de los Andes School of Medicine, Bogotá DC, Colombia
| | - Carlos Gustavo Trujillo
- Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá DC, Colombia.,School of Medicine, Universidad de los Andes School of Medicine, Bogotá DC, Colombia
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The long-term effects of bariatric surgery on female urinary incontinence. Eur J Obstet Gynecol Reprod Biol 2018; 231:15-18. [DOI: 10.1016/j.ejogrb.2018.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/12/2018] [Accepted: 10/02/2018] [Indexed: 11/23/2022]
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Laterza RM, Halpern K, Ulrich D, Graf A, Tamussino K, Umek W. Influence of age, BMI and parity on the success rate of midurethral slings for stress urinary incontinence. PLoS One 2018; 13:e0201167. [PMID: 30114195 PMCID: PMC6095512 DOI: 10.1371/journal.pone.0201167] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/09/2018] [Indexed: 11/26/2022] Open
Abstract
Aims Our aim was to evaluate, in a second data analysis of the prospective randomized controlled trial conducted by Austrian Urogynaecology Working Group, the effect of age, BMI and parity at the time of surgery on short- and long-term outcomes of women primarily treated for SUI (stress urinary incontinence) with midurethral slings. Methods In the original study 554 patients received randomly a retropubic (TVT) or a transobturator midurethral (TVT-O) sling procedure. 480 (87%) and 277 (50%) patients were available for a follow-up efficacy evaluation at 3 months and 5 years respectively. Results Higher age and BMI at surgery appear to lead to a larger probability to have a positive stress test 5 years after surgery, but not after 3 months. Older patients seem to have a worse perception of improvement 5 years after surgery as compared to younger ones, as described by the PGI-I score. Age and BMI do not affect significantly the quality of life of women surgically treated for SUI, as reflected by the results of King´s Health Questionnaire. Parity does not seem to have any effect on objective and subjective surgical outcomes. Conclusions Higher age and BMI at surgery have a detrimental influence on the objective cure rate at 5 years after midurethral sling surgery; higher age also has a negative influence on subjective long-term outcomes. However, these demographic parameters do not influence significantly the quality of life of patients after anti-incontinence surgery. Parity does not show any significant influence on success rate of midurethral sling.
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Affiliation(s)
- Rosa Maria Laterza
- Department of Obstetrics and Gynaecology, Division of General Gynaecology and Gynaecologic Oncology, Medical University of Vienna, Vienna, Austria
- Karl-Landsteiner-Institut fuer Spezielle Gynaekologie und Geburtshilfe, Vienna, Austria
- * E-mail:
| | - Ksenia Halpern
- Department of Obstetrics and Gynaecology, Division of General Gynaecology and Gynaecologic Oncology, Medical University of Vienna, Vienna, Austria
| | - Daniela Ulrich
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Alexandra Graf
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Karl Tamussino
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Wolfgang Umek
- Department of Obstetrics and Gynaecology, Division of General Gynaecology and Gynaecologic Oncology, Medical University of Vienna, Vienna, Austria
- Karl-Landsteiner-Institut fuer Spezielle Gynaekologie und Geburtshilfe, Vienna, Austria
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Dogan O, Basbug A, Kaya AE, Pulatoglu C, Yassa M. A randomized prospective comparison of the needleless mini-sling “hammock” and “U-shape” configurations for management of stress urinary incontinence: 18 month follow-up results. Arch Gynecol Obstet 2018; 297:1483-1493. [DOI: 10.1007/s00404-018-4755-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/14/2018] [Indexed: 01/17/2023]
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Qian J, Luo D. Reply to letter to the editor re: Does body mass index influence the outcome of midurethral sling procedures for stress urinary incontinence? Int Urogynecol J 2017; 29:175-176. [PMID: 29103163 DOI: 10.1007/s00192-017-3502-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 10/09/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Jialei Qian
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Deyi Luo
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
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Re: Does body mass index influence the outcome of midurethral sling procedures for stress urinary incontinence? Int Urogynecol J 2017; 29:173-174. [PMID: 29103162 DOI: 10.1007/s00192-017-3501-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/09/2017] [Indexed: 10/18/2022]
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