Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study
There is enough evidence to support weight loss in order to improve urinary incontinence. Nevertheless, weight loss and maintaining a lower weight are not easy to achieve in the general population. Our study aims to evaluate whether bariatric surgery has a positive effect on the symptoms of urinary...
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MDPI AG
2023-09-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/13/9/1897 |
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| author | Cristian Persu Remus Nicolae Cartas Irina Ciofu Bogdan Mastalier Victor Mihail Cauni |
| author_facet | Cristian Persu Remus Nicolae Cartas Irina Ciofu Bogdan Mastalier Victor Mihail Cauni |
| author_sort | Cristian Persu |
| collection | DOAJ |
| description | There is enough evidence to support weight loss in order to improve urinary incontinence. Nevertheless, weight loss and maintaining a lower weight are not easy to achieve in the general population. Our study aims to evaluate whether bariatric surgery has a positive effect on the symptoms of urinary incontinence in female patients. We performed a prospective study on obese female patients before and after bariatric surgery, over a period of 9 years. Patients with a BMI ≥ 33 kg/m<sup>2</sup> were included if they described involuntary loss of urine and no previous surgery for urinary incontinence was performed. The patients underwent laparoscopic surgery, either gastric sleeve, bypass or banding, performed by four surgeons in our hospital. The type of incontinence was not assessed at the initial visit carried out by the surgeon. All patients who declared being incontinent were referred to the urologist where they received the ICIQ—UI-SF questionnaire before their bariatric surgery and during follow -up visits. The sum of points obtained at questions 3, 4 and 5 was used to evaluate the severity of incontinence, as well as the impact on the quality of life. Our evaluation collected data on age, time since onset of symptoms, pad usage, number and type of deliveries, concomitant conditions and medications. The type of incontinence was assessed by the urologist before bariatric surgery as urge, stress or mixed incontinence. At follow-up visits, the patients were also asked to fill out a 10-point VAS questionnaire evaluating their perception on the evolution of incontinence symptoms. Data were analyzed using <i>t</i>-test statistical analysis. Our objective defined changes in incontinence as cure, improved, no change and worse. We included 54 women from whom initial data and at least 18 months of follow-up were available. We observed that about 50% of all women undergoing bariatric surgery have some degree of urinary incontinence. The ICIQ score improved from 13.31 ± 5.18 before surgery to 8.30 ± 4.49 points after surgery (<i>p</i> < 0.0001). Before surgery, 38 patients (70%) described severe incontinence compared to only 20 patients (37%) after surgery. A total of 16 women (31%) reported complete cure of urinary incontinence after bariatric surgery. Data from the VAS questionnaire show improvement in 46 cases (85%). Pad usage improved from 7.04 ± 2.79 to 3.42 ± 2.77 (<i>p</i> < 0.001) per day. The number of patients using more than one pad per day decreased from 35 (65%) to 9 (17%). The type of incontinence did not seem to be relevant, but our sample size was too small to lead to statistically significant results. There was no impact on the outcome of incontinence of number/type of delivery, age or BMI. Our data show that bariatric surgery is able to cure urinary incontinence in one of three obese women. A significant improvement was obtained in more than two-thirds of the patients, regardless of the type of incontinence. For an obese female with urinary incontinence, treatment for obesity should prevail and incontinence should be treated only if symptoms remain. |
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| spelling | doaj.art-952830dde9ee4ad0996a607ca6a883842023-11-19T11:37:49ZengMDPI AGLife2075-17292023-09-01139189710.3390/life13091897Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center StudyCristian Persu0Remus Nicolae Cartas1Irina Ciofu2Bogdan Mastalier3Victor Mihail Cauni4Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Urology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Urology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Urology, Colentina Clincal Hospital, 020125 Bucharest, RomaniaDepartment of Urology, Colentina Clincal Hospital, 020125 Bucharest, RomaniaThere is enough evidence to support weight loss in order to improve urinary incontinence. Nevertheless, weight loss and maintaining a lower weight are not easy to achieve in the general population. Our study aims to evaluate whether bariatric surgery has a positive effect on the symptoms of urinary incontinence in female patients. We performed a prospective study on obese female patients before and after bariatric surgery, over a period of 9 years. Patients with a BMI ≥ 33 kg/m<sup>2</sup> were included if they described involuntary loss of urine and no previous surgery for urinary incontinence was performed. The patients underwent laparoscopic surgery, either gastric sleeve, bypass or banding, performed by four surgeons in our hospital. The type of incontinence was not assessed at the initial visit carried out by the surgeon. All patients who declared being incontinent were referred to the urologist where they received the ICIQ—UI-SF questionnaire before their bariatric surgery and during follow -up visits. The sum of points obtained at questions 3, 4 and 5 was used to evaluate the severity of incontinence, as well as the impact on the quality of life. Our evaluation collected data on age, time since onset of symptoms, pad usage, number and type of deliveries, concomitant conditions and medications. The type of incontinence was assessed by the urologist before bariatric surgery as urge, stress or mixed incontinence. At follow-up visits, the patients were also asked to fill out a 10-point VAS questionnaire evaluating their perception on the evolution of incontinence symptoms. Data were analyzed using <i>t</i>-test statistical analysis. Our objective defined changes in incontinence as cure, improved, no change and worse. We included 54 women from whom initial data and at least 18 months of follow-up were available. We observed that about 50% of all women undergoing bariatric surgery have some degree of urinary incontinence. The ICIQ score improved from 13.31 ± 5.18 before surgery to 8.30 ± 4.49 points after surgery (<i>p</i> < 0.0001). Before surgery, 38 patients (70%) described severe incontinence compared to only 20 patients (37%) after surgery. A total of 16 women (31%) reported complete cure of urinary incontinence after bariatric surgery. Data from the VAS questionnaire show improvement in 46 cases (85%). Pad usage improved from 7.04 ± 2.79 to 3.42 ± 2.77 (<i>p</i> < 0.001) per day. The number of patients using more than one pad per day decreased from 35 (65%) to 9 (17%). The type of incontinence did not seem to be relevant, but our sample size was too small to lead to statistically significant results. There was no impact on the outcome of incontinence of number/type of delivery, age or BMI. Our data show that bariatric surgery is able to cure urinary incontinence in one of three obese women. A significant improvement was obtained in more than two-thirds of the patients, regardless of the type of incontinence. For an obese female with urinary incontinence, treatment for obesity should prevail and incontinence should be treated only if symptoms remain.https://www.mdpi.com/2075-1729/13/9/1897urinary incontinencebariatric surgeryobesitystress incontinenceurgency incontinencemixed incontinence |
| spellingShingle | Cristian Persu Remus Nicolae Cartas Irina Ciofu Bogdan Mastalier Victor Mihail Cauni Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study Life urinary incontinence bariatric surgery obesity stress incontinence urgency incontinence mixed incontinence |
| title | Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study |
| title_full | Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study |
| title_fullStr | Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study |
| title_full_unstemmed | Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study |
| title_short | Is Surgical Treatment for Obesity Able to Cure Urinary Incontinence in Women?—A Prospective Single-Center Study |
| title_sort | is surgical treatment for obesity able to cure urinary incontinence in women a prospective single center study |
| topic | urinary incontinence bariatric surgery obesity stress incontinence urgency incontinence mixed incontinence |
| url | https://www.mdpi.com/2075-1729/13/9/1897 |
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