TY - JOUR
T1 - Effects of Obesity on Urogynecologic Prolapse Surgery Outcomes
T2 - A Systematic Review and Meta-analysis
AU - Ringel, Nancy E.
AU - Lenger, Stacy M.
AU - High, Rachel
AU - Alas, Alexandriah
AU - Houlihan, Sara
AU - Chang, Olivia H.
AU - Pennycuff, Jon
AU - Singh, Ruchira
AU - White, Amanda
AU - Lipitskaia, Lioudmila
AU - Behbehani, Sadikah
AU - Sheyn, David
AU - Kudish, Bela
AU - Nihira, Mikio
AU - Sleemi, Ambereen
AU - Grimes, Cara
AU - Gupta, Ankita
AU - Balk, Ethan M.
AU - Antosh, Danielle D.
N1 - Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.
PY - 2024/4/1
Y1 - 2024/4/1
N2 - OBJECTIVE: 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.DATA SOURCES: 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.METHODS OF STUDY SELECTION: 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.TABULATION, INTEGRATION, AND RESULTS: 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).CONCLUSION: Obesity is associated with increased likelihood of prolapse recurrence and mesh complications after POP repair.SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022326255.
AB - OBJECTIVE: 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.DATA SOURCES: 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.METHODS OF STUDY SELECTION: 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.TABULATION, INTEGRATION, AND RESULTS: 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).CONCLUSION: Obesity is associated with increased likelihood of prolapse recurrence and mesh complications after POP repair.SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022326255.
KW - Female
KW - Humans
KW - Gynecologic Surgical Procedures/adverse effects
KW - Pelvic Organ Prolapse/surgery
KW - Uterine Prolapse/surgery
KW - Vagina/surgery
KW - Obesity/complications
KW - Surgical Mesh
UR - http://www.scopus.com/inward/record.url?scp=85188761048&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85188761048&partnerID=8YFLogxK
U2 - 10.1097/AOG.0000000000005525
DO - 10.1097/AOG.0000000000005525
M3 - Review article
C2 - 38330397
AN - SCOPUS:85188761048
SN - 0029-7844
VL - 143
SP - 539
EP - 549
JO - Obstetrics and Gynecology
JF - Obstetrics and Gynecology
IS - 4
ER -