Elsevier

Surgery for Obesity and Related Diseases

Volume 3, Issue 6, November–December 2007, Pages 586-590
Surgery for Obesity and Related Diseases

Original article
Bariatric surgery improves urinary incontinence in morbidly obese individuals

Presented at the 24th Annual Meeting of the American Society for Bariatric Surgery, June 11–16, 2007, San Diego, California
https://doi.org/10.1016/j.soard.2007.08.007Get rights and content

Abstract

Background

Urinary incontinence is common in obese individuals. We report on the prevalence of urinary incontinence in patients undergoing bariatric surgery and the effect of surgically induced weight loss on urinary incontinence.

Methods

The prospectively collected data from 201 consecutive candidates for bariatric surgery were evaluated. The patients were surveyed using a questionnaire regarding the duration of incontinence, stress/urge incontinence symptoms, and incontinence severity before and after undergoing bariatric surgery. Severity was quantified using a validated index developed Data are presented as the mean ± standard deviation.

Results

Of 201 patients, 65 (32%) reported urinary incontinence. Of the 65 patients, 44 women and 1 man (age 49 ± 11 years, body mass index 48 ± 7 kg/m2) underwent Roux-en-Y gastric bypass (n = 42) or laparoscopic-assisted gastric banding (n = 3). Of the 38 patients who reported mild (2%), moderate (48%), and severe (50%) urinary incontinence preoperatively who had complete follow-up at ≥6 months postoperatively, 19 (50%) had demonstrated resolution of urinary incontinence and 19 had reported residual slight-moderate (37%) or severe (13%) urinary incontinence. The overall severity score improved from 5.4 ± 2.3 to 2.3 ± 2.8 postoperatively (P <.001); the percentage of excess body weight loss was 61% ± 19%. The patients reported subjective improvement within 4 months postoperatively or after a 50-lb weight loss.

Conclusion

Urinary incontinence is prevalent in bariatric surgery patients. Surgically induced weight loss results in improvement or resolution of urinary incontinence in 82% of patients. The findings from this large cohort warrant additional investigation with urodynamic studies.

Section snippets

Methods

This study was conducted with approval of the institutional review board of the University of South Florida and in compliance with Health Insurance Portability and Accountability Act regulations.

Results

Of the 201 patients, 65 (32%) reported urinary incontinence. Of the 65 patients, 20 were awaiting surgery or had been denied surgery for various reasons. Therefore, we analyzed the data from 45 patients with urinary incontinence who had undergone bariatric surgery during the study period.

All but 1 of the 45 patients were women. Their mean age was 49 ± 11 years, and the mean BMI was 48 ± 7 kg/mg2. Most patients (93%) underwent Roux-en-Y gastric bypass, including 1 revisional Roux-en-Y gastric

Discussion

Urinary incontinence in morbidly obese individuals affects nearly 17 million Americans, at an estimated cost of $19.5 billion dollars [11]. This widespread prevalence is underestimated in the clinical setting, because patients often fail to report minor degrees of incontinence. In our study, we found urinary incontinence in one third of bariatric patients, most of whom reported moderate to severe symptoms (96%). Our findings are similar to those reported from smaller cohorts (28–67%) [12], [13]

Conclusion

The findings of our study have indicated that bariatric surgery results in marked improvement in urinary incontinence in most patients and could obviate the need for operative treatment of urinary incontinence in obese patients. Additional studies are warranted to elucidate the role of urodynamic studies for patients with persisting or worsening urinary incontinence after weight loss surgery and the potential role of urologic surgery.

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

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