Effects of Obesity on Urogynecologic Prolapse Surgery Outcomes: A Systematic Review and Meta-analysis.

Journal

Obstetrics and gynecology
ISSN: 1873-233X
Titre abrégé: Obstet Gynecol
Pays: United States
ID NLM: 0401101

Informations de publication

Date de publication:
08 Feb 2024
Historique:
received: 13 11 2023
accepted: 21 12 2023
medline: 8 2 2024
pubmed: 8 2 2024
entrez: 8 2 2024
Statut: aheadofprint

Résumé

To systematically review the literature on outcomes of pelvic organ prolapse (POP) surgery in patients from various body mass index (BMI) categories to determine the association between obesity and surgical outcomes. PubMed, EMBASE, and Cochrane databases were searched from inception to April 12, 2022; ClinicalTrials.gov was searched in September 2022 (PROSPERO 2022 CRD42022326255). Randomized and nonrandomized studies of urogynecologic POP surgery outcomes were accepted in which categories of BMI or obesity were compared. In total, 9,037 abstracts were screened; 759 abstracts were identified for full-text screening, and 31 articles were accepted for inclusion and data were extracted. Studies were extracted for participant information, intervention, comparator, and outcomes, including subjective outcomes, objective outcomes, and complications. Outcomes were compared among obesity categories (eg, BMI 30-34.9, 35-40, higher than 40), and meta-analysis was performed among different surgical approaches. Individual studies reported varying results as to whether obesity affects surgical outcomes. By meta-analysis, obesity (BMI 30 or higher) is associated with an increased odds of objective prolapse recurrence after vaginal prolapse repair (odds ratio [OR] 1.38, 95% CI, 1.14-1.67) and after prolapse repair from any surgical approach (OR 1.31, 95% CI, 1.12-1.53) and with complications such as mesh exposure after both vaginal and laparoscopic POP repair (OR 2.10, 95% CI, 1.01-4.39). Obesity is associated with increased likelihood of prolapse recurrence and mesh complications after POP repair. PROSPERO CRD42022326255.

Identifiants

DOI: 10.1097/AOG.0000000000005525 PMID: 38330397
pubmed: 38330397
doi: 10.1097/AOG.0000000000005525
pii: 00006250-990000000-01018
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

Financial Disclosure Alexandriah Alas received payments for expert testimony. Sadikah Behbehani received payments from Intuitive Surgical. Jon Pennycuff receives consulting fees from Boston Scientific, Coloplast, Corneille Law, LLC, and ICA, Inc. David Sheyn received payments from Caldera Medical, and his institution received payment from Medtronic and Axonics. Bela Kudish has served as a consultant for Proctor for Intuitive Surgical. Mikio Nihira received payment from HealthTrust and Shield Therapeutics. Cara Grimes received payments from Provepharm, Inc for consultant work and from Johnson and Johnson as an expert witness and is an SGS Board member. Ethan M. Balk receives funding from SGS as a consultant methodologist to the Systematic Review Group. Danielle Antosh received past payments from LaGrippe Research Inc. The other authors did not report any conflicts of interest.

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Auteurs

Nancy E Ringel (NE)

Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut; the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Women's Health, University of Louisville, Louisville, Kentucky; the Division of Urogynecology, Department of Obstetrics and Gynecology, Houston Methodist, Houston, the Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, and the Department of Obstetrics and Gynecology, University of Texas at Austin Dell Medical School, Austin, Texas; the Department of Obstetrics and Gynecology, Royal Columbian Hospital, University of British Columbia, Vancouver, British Columbia, Canada; the Division of Female Urology and Pelvic Reconstructive Surgery, Department of Urology, University of California, Irvine, Orange, the Department of Obstetrics and Gynecology, University of California, Riverside School of Medicine, Riverside, and KPC Healthcare, Hemet, California; the Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; the Department of Obstetrics and Gynecology, University of Florida Health, Jacksonville, and Bela Vida Urogynecology, Celebration, Florida; the Division of Urogynecology, Department of Obstetrics and Gynecology, Cooper Health University, Camden, New Jersey; the Department of Urology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; the International Medical Response Foundation, Brooklyn, and the Departments of Obstetrics and Gynecology and Urology, New York Medical College, Valhalla, New York; and the Center for Evidence Synthesis in Health, Brown School of Public Health, Brown University, Providence, Rhode Island.

Stacy M Lenger (SM)

Rachel High (R)

Alexandriah Alas (A)

Sara Houlihan (S)

Olivia H Chang (OH)

Jon Pennycuff (J)

Ruchira Singh (R)

Amanda White (A)

Lioudmila Lipitskaia (L)

Sadikah Behbehani (S)

David Sheyn (D)

Bela Kudish (B)

Mikio Nihira (M)

Ambereen Sleemi (A)

Cara Grimes (C)

Ankita Gupta (A)

Ethan M Balk (EM)

Danielle D Antosh (DD)

Classifications MeSH