Bohlin KS, et al. - The purpose of this study was to evaluate the impact of obesity and other risk factors on the outcome of anterior and posterior colporrhaphy with and without mesh. Based on these outcomes, obesity affected the sensation of a vaginal bulge and the presence of urinary incontinence (UI) after primary surgery but not on complications.

Methods

• Information was retrieved from the Swedish National Register for Gynecological Surgery on 18,554 women undergoing primary and repeat POP surgery without concomitant urinary incontinence (UI) surgery between 2006 and 2015.
• Multivariate logistic regression investigations were utilized to identify independent risk factors for a sensation of a vaginal bulge, de novo UI, and residual UI 1 year after surgery.

Results

• The overall subjective cure rate 1 year after surgery was 80% (with mesh 86.4% vs 77.3% without mesh, p < 0.001).
• The complication rate was low, but was more frequent in repeat surgery that were mainly mesh related.
• The utilization of mesh was also connected with more frequent de novo UI, but patient satisfaction and cure rates were higher compared with surgery without mesh.
• Preoperative sensation of a vaginal bulge, severe postoperative complications, anterior colporrhaphy, prior hysterectomy, postoperative infections, local anesthesia, and body mass index (BMI) ≥ 30 were risk factors for sensation of a vaginal bulge 1 year postsurgery.
• Obesity had no impact on complication rates but was related increased urinary incontinence (UI) after primary surgery.
• Obesity had no influence on cure or voiding status in women undergoing repeat surgery.