THE LONG TERM EFFECTS OF BARIATRICSURGERY ON FEMALE URINARY INCONTINENCE.
B. C. ANGLIM1, C.O'BOYLE 2, O. O'SULLIVAN 1, C. O'SULLIVAN 2,B. A. O'REILLY 3;
1Cork Univ. MaternityHosp., Cork, Ireland, 2Department of Bariatrics, BonsSecours Hosp., Cork, Ireland, 3CUMH, Cork, Ireland.
Introduction: Obesity is anemerging challenge within the medical field and is now a globalpandemic. Obesity has been shown to negatively impact pelvic floorsupport and associated incontinence, particularly stressincontinence.
Objective: The aim of this study is todetermine the impact on urinary incontinence of women at twelvemonths post bariatric surgery.
Methods: A prospectivecohort study was performed of all patients undergoing bariatricsurgery between January 2008 to January 2017, who had urinaryincontinence prior to their operation. During this period 481patients underwent bariatric surgery, of which 366 were female.Incontinence was assessed using the International Consultation onIncontinence Questionnaire- Urinary Incontinence short form (ICIQ-UISF).
Results: 41% (151/366) of women filled out theincontinence questionnaire pre-operatively, and of these 40% (61/151)completed the questionnaire at one year post-operatively. The meanage of participants was 50 (SD=8.39). The mean pre-operative weightand BMI were 136kg (SD=21.3) and 51kg/m2 respectively(SD=7.1). The mean post-operative weight drop was 49kg (SD=21kg), andpercentage excess weight loss was 74%. 66% underwent laparoscopicgastric bypass, and the remainder underwent sleeve gastrectomy. 34%reported symptoms of stress incontinence (SUI), 21% reported symptomsof overactive bladder (OAB), and 44% reported symptoms of mixedincontinence. The cure rates post-operatively for SUI, OAB and mixedincontinence, were 41%, 38% and 48% respectively, however this didnot reach statistical significance. 61% of women wore pads on a dailybasis pre-operatively compared to 36% postoperatively, which showedan overall 80% improvement (p <0.01 using chi square test). 44% ofwomen reported complete resolution of their symptoms. Using theICIQ-UI SF, the mean score was reduced by 4.8 (SD=5), from 9.3(SD=4.4) pre-operatively to 4.5 (SD=5) post-operatively.
Conclusions:Bariatric surgery results in a clinically significant long-termimprovement in urinary incontinence, with a significant cure rate atone year post bariatric surgery. The improvement in severity score,based on the Incontinence Questionnaire used, did not correlate toreduction in post-operative BMI (correlation coefficient-0.11).
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