One-year outcomes of tension-free vaginal tape (TVT) mid-urethral slings in overweight and obese women.

INTRODUCTION: The purpose of this study was to assess the impact of body mass index (BMI) on tension-free vaginal tape (TVT) success rates, patient satisfaction, and complications 1 year following surgery. METHODS: Baseline and 1-year postsurgery outcomes were abstracted, including Urogenital Distress Inventory (UDI-6) scores, Incontinence Impact Questionnaire (IIQ-7) scores, and patient satisfaction ratings. Multivariable logistic and linear regression analyses were performed to examine relationships between outcomes and BMI. RESULTS: Subjects (N = 195) with a mean age of 59.3 +/- 12.6 were included. There was significant improvement within each group (all p values <0.01) in total UDI-6 and IIQ-7 scores from baseline to 1 year postsurgery; all groups had high patient satisfaction. No differences in improvement or complications rates were observed among the BMI cohorts (all p values >0.05). CONCLUSION: Differential counseling of overweight or obese women regarding outcomes of the TVT procedure is not supported by these results; longer follow-up is warranted.

Patient-centered treatment goals for pelvic floor disorders: association with quality-of-life and patient satisfaction.

OBJECTIVE: We sought to determine the relationship of patient-centered goal achievement in pelvic floor disorder (PFD) treatment to PFD-specific quality-of-life (QOL), depression, health status, and patient satisfaction. STUDY DESIGN: Ninety women with PFD identified up to 5 goals for treatment and reported their level of goal attainment (-2 to +2) at 1.5, 3, 6, and 12 months; completed the Incontinence Impact Questionnaire, Urogenital Distress Inventory, Incontinence Quality-of-Life Scale, Patient Health Questionnaire, and Short Form-12 Health Survey; and indicated their satisfaction with treatment. RESULTS: Twelve-month mean goal attainment was moderately correlated with PFD-specific measures of QOL (r range, -0.40 to 0.55; P < .05) but less strongly with depression and general health status (r range, -0.27 to 0.28). Twelve-month goal attainment differed significantly among those who were completely satisfied (1.6 +/- 0.5), very satisfied (1.2 +/- 0.6), satisfied (0.4-1.0), or not satisfied (-0.5 +/- 0.9; F = 24.2; P < .01). Earlier follow-up results were similar. CONCLUSION: PFD treatment goal attainment is associated with improved condition-specific QOL and patient satisfaction.