Postoperative Body Weight Changes and Effect on Midurethral Sling Failure

Importance Little is known about the effect of weight change following surgery on midurethral sling outcomes. Objective The objective of this study was to determine the effect of body weight change after midurethral sling on the 24-month subjective outcome. We hypothesized that body weight gain would increase the chance of subjective failure. Study Design This was a secondary analysis of the Trial of Mid-Urethral Slings. The primary outcome was subjective failure at 24 months postoperatively. Secondary outcomes include objective failure and combined (objective/subjective) failure at 24 months. Weight change was categorized as no change (if ±5 lb of baseline), gain (>5 lb above), and loss (>5 lb below) at baseline. In addition, we categorized for percentage weight change of baseline body weight (±5%, 5–10%, and >10%). The association between weight change and outcomes was evaluated using logistic regression. Results Four hundred thirty-two participants were included. Weight loss or gain of >5 lb was not significantly associated with 24-month subjective failure (weight loss odds ratio [OR]: 1.54, 95% CI: 0.96–2.49; weight gain OR: 1.51, 95% CI: 0.96–2.36). In addition, no significant association was observed with 24-month objective or combined failure (Objective: weight loss OR: 1.23, 95% CI: 0.73–2.08; weight gain OR: 1.11, 95% CI: 0.67–1.82; Combined failure: weight loss OR: 1.32, 95% CI: 0.82–2.13, weight gain OR: 1.47, 95% CI: 0.94–2.31). Participants with weight gain >10% baseline body weight had significantly increased odds of combined failure at 24 months (OR: 2.75, 95% CI: 1.13–6.69). Conclusions Significant body weight gain (>10%) following midurethral sling placement is associated with increased odds of combined failure of the surgery at 24 months.