The long-term effects of bariatric surgery on female urinary incontinence

Introduction: Obesity has been shown to negatively impact pelvic floor support and associated urinary incontinence (UI), however little is known regarding the long-term effect of bariatric surgery on urinary incontinence. Objective: The aim of this study is to determine the impact of bariatric surgery on female UI at twelve months post-operatively. Study Design: A prospective cohort study was performed of all patients undergoing bariatric surgery who reported UI between January 2008 to January 2017. Results: Three hundred and sixty-six women undergoing bariatric surgery and filled out the ICIQ-UI SF questionnaire. Of these 44% (151/366) had UI pre-operatively, and of these 40% (61/151) completed the questionnaire at one year post-operatively. The mean pre-operative weight and body mass index (BMI) were 136 (21.3)kg and 51(7.1) kg/m(2) respectively. The percentage excess weight loss was 74%. Sixty-six percent underwent laparoscopic gastric bypass, and the remainder underwent sleeve gastrectomy. Thirty-four percent reported stress incontinence (SUI), 21% reported overactive bladder (OAB), and 44% reported mixed incontinence. The cure rates post-operatively for SUI, OAB and mixed incontinence, were 41%, 38% and 48% respectively, and there was a 40% improvement in UI when assessing pad use (p < 0.001). Using the ICIQ-UI SF, the mean score was reduced by 4.8 (5), from 9.3 (4) pre-operatively to 4.5 (5) post-operatively. Conclusion: Bariatric surgery results in a clinically significant long-term improvement in UI, with a significant cure rate at one year post bariatric surgery. The improvement in severity score, based on the Incontinence Questionnaire used, did not correlate with reduction in post-operative BMI. (C) 2018 Elsevier By. All rights reserved.