Bariatric surgery improves urinary incontinence in morbidly obese individuals

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.

Keywords: Obesity, Weight loss, Gastric bypass, Laparoscopic-assisted gastric banding, Resolution of co-morbidities