Therapeutics and Clinical Risk Management (Jan 2017)
Effects of bariatric surgery on urinary incontinence
Abstract
Nurullah Bulbuller,1 Mani Habibi,1,2 Mustafa Yuksel,3 Onur Ozener,1 Mehmet Tahir Oruc,1 Osman Zekai Oner,1 Mehmet Altug Kazak1 1General Surgery Department, Antalya Training and Research Hospital, Antalya, 2General Surgery Department, Esenler Maternity and Child Health Hospital, Istanbul, 3Urology Department, Antalya Training and Research Hospital, Antalya, Turkey Introduction: Obesity is an important modifiable etiological factor associated with several diseases. There is strong evidence that urinary incontinence (UI) is positively correlated with body mass index (BMI). Aim: One of the many benefits experienced by obese patients after bariatric surgery is decrease in UI. To investigate this correlation, we aimed to examine the effects of weight loss on UI in female patients who had undergone laparoscopic sleeve gastrectomy (LSG). Materials and methods: Obese female patients (n=120), ≥18 years of age, and planning to undergo LSG were included in this prospective study. We administered the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) and Incontinence Impact Questionnaire (IIQ-7) to the patients prior to surgery and 6 months after the surgery. Using the collected data, we determined the incidence of UI and examined the relationship between the preoperative and postoperative BMI and UI values. Results: The mean age of the patients was 39.19 (standard deviation [SD] =9.94) years and the mean preoperative BMI was 46.17 (SD =5.35). Of the 120 patients, 72 (60%) complained of UI preoperatively. Among these 72 patients, 23 (31.95%) described urge incontinence, 18 (25%) stress incontinence, and 31 (43.05%) mixed-type incontinence. At 6 months postoperatively, the percentage of excess weight loss was 70.33% (SD =14.84%). For all three UI subtypes, the 6-month postoperative ICIQ-UI-SF and IIQ-7 scores decreased significantly compared to the preoperative scores (P<0.05). Conclusion: LSG results in a clinically significant improvement in most common types of UI, regardless of patient reproductive history, existence of comorbid conditions, and smoking status. Keywords: bariatric surgery, obesity, urinary incontinence