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16-08-2023 | Urinary Incontinence | 2023 SAGES Oral

Urinary incontinence in women who have undergone bariatric surgery

Authors: K. Paige Mihalsky, Rachel Tran, Fernando Moreno-Garcia, Caitlin Stenberg, Fernando Mier Giraud, Adam Hare, Lieschen H. Quiroz, Laura E. Fischer

Published in: Surgical Endoscopy | Issue 11/2023

Abstract

Introduction

Obesity is a known risk factor for urinary incontinence (UI). As bariatric surgery can result in significant and sustainable weight loss, many chronic diseases closely linked to obesity have likewise shown improvement after surgical weight loss. We propose that bariatric surgery may significantly improve obesity-related UI symptoms as well as improve quality of life.

Methods and procedures

This is an interim analysis of an ongoing, prospective, single-institution observational study looking at UI in women enrolled in a bariatric surgery program. Participants completed the Pelvic Floor Distress Inventory (PFDI-20), International Consultation on Incontinence Questionnaire—Urinary Incontinence Short Form (ICIQ-UI-SF), King’s Health Questionnaire (KHQ), and Patient Global Impression of Improvement (PGI-I). Questionnaires were administered upon enrollment, pre-operatively, and at 3, 6, and 12 months post-operatively. Demographic data were collected at each interval and analyzed with descriptive statistics.

Results

At analysis, 108 patients had enrolled in the study and 60% had progressed to surgery. We analyzed the following surveys: enrollment (n = 108), pre-operative (n = 43), 3-month (n = 29), 6-month (n = 26), and 1-year (n = 27). Mean BMI decreased from 49.8 to 31.1 at 1-year. All surveys showed significant improvement in UI symptoms over time. Overall, UI symptoms (PDFI-20) are correlated with BMI at time of survey and %TBWL (p = 0.03, p = 0.019). Additionally, perception of symptom improvement with surgery (PGI-I) improved over time (3-month p = 0.0289, 6-month p = 0.0024, 12-month p = 0.0035). Quality of life related to UI symptoms (KHQ) significantly improved after surgery (p = 0.0047 3-month, p = 0.0042 6-month, p = 0.0165 1-year).

Conclusions

Although the relationship is complex and likely depends on many factors, weight loss after bariatric surgery is associated with improvement in UI symptoms and UI-related quality of life. Bariatric surgery can play a role in the long-term treatment of UI in women with obesity that may negate the need for further invasive UI procedures.

Graphical abstract

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Title: Urinary incontinence in women who have undergone bariatric surgery
Authors: K. Paige Mihalsky
Rachel Tran
Fernando Moreno-Garcia
Caitlin Stenberg
Fernando Mier Giraud
Adam Hare
Lieschen H. Quiroz
Laura E. Fischer
Publication date: 16-08-2023
Publisher: Springer US
Keywords: Urinary Incontinence
Urinary Incontinence
Bariatric Surgery
Bariatric Surgery
Obesity
Obesity
Published in: Surgical Endoscopy / Issue 11/2023
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10299-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Urinary incontinence in women who have undergone bariatric surgery

Abstract

Introduction

Methods and procedures

Results

Conclusions

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods and procedures

Results

Conclusions

Graphical abstract

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