Association of body mass index with thigh pain after transobturatormidurethral sling for female stress incontinence

HAN J1, OH M2, KIM S3

Research Type

Clinical

Abstract Category

Female Stress Urinary Incontinence (SUI)

Abstract 608
E-Poster 3
Scientific Open Discussion Session 31
Friday 6th September 2019
13:10 - 13:15 (ePoster Station 6)
Exhibition Hall
Pain, Pelvic/Perineal Stress Urinary Incontinence Female Surgery
1.Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, 2.Korea University Guro Hospital, Seoul, Korea, 3.Yonsei University Wonju College of Medicine, Wonju, Korea
Presenter
J

Ji Yeon Han

Links

Abstract

Hypothesis / aims of study
The most widespread midurethral sling is the transobturator approach, in which passage of the tape is through the obturator foramen, rather than retropubically through the space of Retzius, thereby decreasing potential complications. The greater potential for injury leading to clinically significant pain or neuropathy remains one of the greatest concerns with transobturator approach. A study found a 16% incidence of groin pain among the patients undergoing transobturator sling1.  This was designed with the assumption of causing more tissue damage in obese patients, thereby increasing postoperative thigh pain. We investigated the incidence of thigh pain after transobturator midurethral sling for female stress urinary incontinence and evaluated the association between thigh pain and body mass index (BMI).
Study design, materials and methods
We retrospectively analyzed the data of seventy-eight women who underwent the transobturator sling outside-in (TOT) procedure and were followed up for at least 1 month. Surgery was performed using a combination of intravenous sedation and local anesthesia. The pain severity in patients was evaluated using the Wong-baker pain rating scale at postoperative day and at postoperative 1 month. Surgical outcome was assessed according to the Severity Index for Urinary Incontinence. Patients were considered cured if they did not report any episodes of urine leakage on the Severity Index for Urinary Incontinence in Women.
Results
The mean BMI was 24.9±3.0 (range 19.4-35.4)Kg/m2 preoperatively and the mean pain scale was 3.0±1.6 (range 0-6) at postoperative day. The pain scale was higher in overweight patients (BMI≥25 Kg/m2) compared with women with normal BMI (3.8±1.7 vs. 2.6±1.4, p=0.002) and analysis of the correlation examined statistically significant associations between pain and BMI (correlation coefficient (r)=0.385, p=0.001) (Figure 1). Nine (11.8%) patients experienced postoperative pain for postoperative 1 month. The cure rate at 1 month postoperatively was 89.7% (70/78) and cure rates were not significantly different according to BMI.
Interpretation of results
Obese women have an increased risk of thigh pain following transobturator midurethral sling compared with women with normal BMI. Understanding these associations will aid clinicians in preoperative counseling and postoperative monitoring.
Concluding message
Obese women have an increased risk of thigh pain following transobturator midurethral sling compared with women with normal BMI. Understanding these associations will aid clinicians in preoperative counseling and postoperative monitoring.
Figure 1
References
  1. Laurikainen E et al. Obstet Gynecol. 2007
Disclosures
Funding none Clinical Trial No Subjects Human Ethics not Req'd retrospective study Helsinki Yes Informed Consent No
28/03/2024 03:37:20