Poster, Podium & Video Sessions
Presentation Authors: Charles Powell*, Bridget Eckrich, Jeffrey Rothenberg, Thomas Gardner, Indianapolis, IN
Introduction: Obesity has been associated with urinary incontinence and may worsen incontinence related complaints following robotic sacral colpopexy (RSC). Elevated Body Mass Index (BMI) may confer an increased risk of denovo stress urinary incontinence (SUI) even when mid urethral sling (MUS) is performed. We sought to determine the risk of denovo stress incontinence following robotic sacral colpopexy in patients with elevated BMI and assess the impact of BMI on postoperative Quality of Life (QoL) metrics.
Methods: Retrospective chart review was undertaken and continence and BMI are noted. BMI was stratified according to the NIH classification. Outcomes were patient reported SUI and pad use, development of denovo SUI after colpopexy, and decision to undergo MUS after RSC. Incontinence was defined as any mention of SUI at any one of the follow up visits when asked directly by the examiner, SUI in the bladder diary, or evidence of SUI on the supine stress test.
Results: Between 2009 and 2015 134 women underwent RSC. 52 patients complained of urinary incontinence pre operatively (38.5%). As BMI increased, the number of pads recorded on preoperative bladder diary also increased, however, following concomitant mid urethral sling there was no difference in number of patients reporting incontinence or pad use at the last postoperative visit (Table 1) over 21.3 months follow up. The denovo rate of urinary incontinence did not increase as the BMI increased and failed to meet statistical significance, with normal BMI having a de−novo SUI rate of 26%, overweight 17%, obese 23%, and extreme obesity 25%, p>0.05.
Conclusions: Obese patients undergoing RSC have increased preoperative pad use and SUI rates but have similar SUI cure rates and denovo SUI rates compared with nonobese patients.
Source Of Funding: none
Indiana University School of Medicine
Dr. CR Powell completed a degree in Electrical Engineering at Purdue University, followed by medical school at the Indiana University School of Medicine. He completed urology residency at the University of Illinois at Chicago in 2008 and was fortunate to complete a fellowship in Female Pelvic Medicine and Reconstructive Surgery at the University of Iowa under Dr. Karl Kreder in 2009. He was hired at the Indiana University School of Medicine, Department of Urology in 2009 and continues to teach, write, and see patients there, rising to the rank of Associate Professor. He has been awarded pilot funding under the NIDDK DIACOMP mechanism for work in metabolic syndrome and its effects on the bladder, has published 21 abstracts and papers since arriving, 7 book chapters and invited articles, and authored one provisional patent while there. His areas of interest include robotic colpopexy, urethroplasty, urinary diversion, neurogenic bladder, including dysfunction from diabetes, sacral neuromodulation, and medical device development in conjunction with the Weldon School of Biomedical Engineering at Purdue University. He has an interest in missions to developing countries and has taken 7 IU residents to Kenya, East Africa to operate as well as multiple trips to Gabon, Honduras, and Mexico.
Monday, May 15
7:10 AM – 7:20 AM