[Obesity as a risk factor to Burch surgery failure].

PURPOSE: to observe the impact of obesity and other risk factors on the rate of failure in patients submitted to Burch's surgery for the treatment of urinary incontinence.

METHODS: cases study of patients submitted to Burch's surgery, from 1992 to 2003. Patients were evaluated at the second post-surgery appointment (average 66 days) and after one-year follow-up, and classified in two groups: Continent and Non-continent. Variables analyzed were: age, parity, body mass index (BMI), menopause duration, duration of hormonal therapy, urodynamic evaluation, history of urinary tract infection, previous urinary incontinence surgery, diabetes, cystocele and uterine prolapse, time spent in hospital, necessity of self-probing, post-surgical spontaneous micturition, and surgical wound. Data were analyzed with the Statistical Package for Social Sciences 14.0 statistical package. For the comparison of continuous variables, Student's t-test or Mann-Whitney test were used, and Fisher exact and chi2 tests, for the categorical variables (p<0.05).

RESULTS: at the second post-surgical evaluation, there was no significant difference between the two groups, concerning the variables analyzed. After one-year follow-up, from a total of 97 patients, 81 were continent and 16, non-continent, BMI and height being different between the groups. In the continent group, average BMI was 27.1 and height, 1.57 m, and, among the non-continent, 30.8 (p=0.02) and 1.52 m (p=0.01). The BMI>30 Odds Ratio was 3.7 (CI95%=1.2-11.5).

CONCLUSIONS: obesity has shown to be an important risk factor for the surgery failure in the first follow-up year. Results show that patients with BMI>30 have 3.7 times more chance of being non-continent one-year after Burch's surgery than non-obese patients.