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Association of body mass index with hip and thigh pain following transobturator midurethral sling placement

Published:August 23, 2010DOI:https://doi.org/10.1016/j.ajog.2010.07.023

      Objective

      We sought to investigate the incidence of hip and proximal lower extremity pain following transobturator midurethral sling and evaluate the association between pain and body mass index (BMI).

      Study Design

      This was a retrospective cohort study of all transobturator midurethral sling procedures from July 2008 through June 2009. The primary outcome was postoperative hip or proximal lower extremity pain.

      Results

      Four urogynecologists performed 226 procedures. The incidence of postoperative hip or proximal lower extremity pain was 15.5%. Women of normal BMI had a higher risk of developing pain than obese women (risk ratio, 2.51; 95% confidence interval, 1.01–6.22). While not statistically significant, overweight women were twice as likely as obese women to develop the primary outcome (risk ratio, 1.99; 95% confidence interval, 0.79–4.99).

      Conclusion

      Women of normal BMI have an increased risk of hip and proximal lower extremity pain following transobturator midurethral sling compared with obese women.

      Key words

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      References

        • Reisenauer C.
        • Kirschniak A.
        • Drews U.
        • Wallwiener D.
        Transobturator vaginal tape inside-out.
        Eur J Obstet Gynecol Reprod Biol. 2006; 127: 123-129
        • Killingsworth L.B.
        • Wheeler T.L.
        • Burgio K.L.
        • Martirosian T.E.
        • Redden D.T.
        • Richter H.E.
        One-year outcomes of tension-free vaginal tape (TVT) mid-urethral slings in overweight and obese women.
        Int Urogynecol J Pelvic Floor Dysfunct. 2009; 20: 1103-1108
        • Ulmsten U.
        • Henriksson L.
        • Johnson P.
        • Varhos G.
        An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence.
        Int Urogynecol J Pelvic Floor Dysfunct. 1996; 7: 81-85
        • Daneshgari F.
        • Kong W.
        • Swartz M.
        Complications of mid-urethral slings: important outcomes for future clinical trials.
        J Urol. 2008; 180: 1890-1897
        • Mellier G.
        • Benayed B.
        • Bretones S.
        • Pasquier J.C.
        Suburethral tape via the obturator route: is the TOT a simplification of the TVT?.
        Int Urogynecol J Pelvic Floor Dysfunct. 2004; 15: 227-232
        • Delorme E.
        Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women.
        Prog Urol. 2001; 11: 1306-1313
        • De Leval J.
        Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out.
        Eur Urol. 2003; 44: 724-730
        • Meschia M.
        • Bertozzi R.
        • Pifarotti P.
        • et al.
        Peri-operative morbidity and early results of a randomized trial comparing TVT and TVT-O.
        Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18: 1257-1261
        • Ross S.
        • Robert M.
        • Swaby C.
        • et al.
        Transobturator tape compared with tension-free vaginal tape for stress incontinence: a randomized controlled trail.
        Obstet Gynecol. 2009; 114: 1287-1294
        • Laurikainen E.
        • Valpas A.
        • Kivela A.
        • et al.
        Retropubic compared with transobturator tape placement in treatment of urinary incontinence: a randomized controlled trial.
        Obstet Gynecol. 2007; 109: 4
        • Latthe P.
        • Foon R.
        • Toozs-Hobson P.
        Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications.
        BJOG. 2007; 114: 522-531
        • Sung V.W.
        • Schleinitz M.D.
        • Rardin C.R.
        • Ward R.M.
        • Myers D.L.
        Comparison of retropubic vs transobturator approach to midurethral slings: a systematic review and meta-analysis.
        Am J Obstet Gynecol. 2007; 197: 3-11
        • Boyles S.
        • Edwards R.
        • Gregory W.
        • Clark A.
        Complications associated with transobturator sling procedures.
        Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18: 19-22
        • Wolter C.
        • Starkman J.
        • Scarpero H.M.
        • Dmochowski R.
        Removal of transobturator midurethral sling for refractory thigh pain.
        J Urol. 2008; 72: 461.e1-461.e3
        • Hazewinkel M.H.
        • Hinoul P.
        • Roovers J.
        Persistent groin pain following a trans-obturator sling procedure for stress urinary incontinence: a diagnostic and therapeutic challenge.
        Int Urogynecol J Pelvic Floor Dysfunct. 2009; 20: 363-365
        • Skriapas K.
        • Poulakis V.
        • Dillenberg W.
        • et al.
        Tension-free vaginal tape (TVT) in morbidly obese patients with severe urodynamic stress incontinence as last option treatment.
        Eur Urol. 2006; 29: 544-550
        • Lovatsis D.
        • Gupta C.
        • Dean E.
        • Lee F.
        Tension-free vaginal tape procedure is an ideal treatment for obese patients.
        Am J Obstet Gynecol. 2003; 189: 1601-1604
        • Hellberg D.
        • Holmgren C.
        • Lanner L.
        • Nilsson S.
        The very obese woman and the very old woman: tension-free vaginal tape for the treatment of stress urinary incontinence.
        Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18: 423-429
        • Firth D.
        Bias reduction of maximum likelihood estimates.
        Biometrika. 1993; 80: 27-38
        • Heinze G.
        • Schemper M.
        A solution to the problem of separation in logistic regression.
        Stat Med. 2002; 21: 2409-2419