This study’s objective was to assess the impact of obesity on surgical complexity using operative time as a surrogate and secondarily evaluate the effect on postoperative pad use.

A total of 62 patients were identified with a median (IQR) follow-up of 14 (4–33) months. Of these, 40 were non-obese, and 22 (35.5%) were obese. When excluding patients who underwent concurrent surgery, the mean operative times for the non-obese versus obese cohorts were 61.8 min versus 73.7 min. No Clavien 3–5 grade complications were noted. At follow-up, 47.5% of the non-obese cohort and 63.6% of the obese cohort reported using one or more pads daily. Four of the five patients with a history of radiation were among the patients wearing pads following male urethral sling placement.

The study concluded that obese men undergoing AdVance male urethral sling placement required increased operative time, potentially related to operative complexity. A higher proportion of obese compared with non-obese patients required postoperative pads for continued urinary incontinence. Further research is necessary to delineate better the full impact of obesity on male urethral sling outcomes.