Obesity Surgery

, Volume 23, Issue 7, pp 931–938

Bariatric Surgery Improves Urinary Incontinence but Not Anorectal Function in Obese Women

  • Gitana Scozzari
  • Fabrizio Rebecchi
  • Claudio Giaccone
  • Paolo Chiaro
  • Massimiliano Mistrangelo
  • Mario Morino
Clinical Research

Abstract

Background

While the association between obesity and urinary incontinence (UI) in women has been clearly documented, the relationship with anal incontinence (AI) is less well defined; moreover, while bariatric surgery has been shown to improve UI, its effect on AI is still unclear.

Methods

A total of 32 obese women were studied by means of PFDI-20 and PFIQ-7 questionnaires and anorectal manometry before and after bariatric surgery and compared with 71 non-obese women.

Results

Obese women showed worse overall questionnaire results (OR 5.18 for PFDI-20 and 2.66 for PFIQ-7). Whereas obese women showed worse results for urinary sub-items and a higher urge UI incidence (43.8 vs 18.3 %, p = 0.013), they did not show worsening in colorecto-anal symptoms. Post-operatively, median PFDI-20 total score did not change (24.2 vs 26.6, p = ns), while there was an improvement in urinary score (14.6 vs 8.3, p < 0.001); median PFIQ-7 improved (4.8 vs 0.0, p = 0.044), but while the urinary score improved (2.4 vs 0.0, p = 0.033), the colorecto-anal score did not change significantly. Although after surgery urge UI decreased from 43.8 to 15.6 % (p = 0.029), the incidence of any AI increased from 28.1 to 40.6 % (p = ns) and flatus incontinence increased from 18.8 to 37.5 % (p = ns). Anorectal manometry did not show significant changes after surgery.

Conclusions

Obese women had worse questionnaire results, but while showing a higher incidence of UI, they did not experience anorectal function worsening. After bariatric surgery, there was a slight improvement in PFD symptoms related to UI, but anorectal function did not change significantly and flatus incontinence increased.

Keywords

Obesity Bariatric surgery Anorectal function Pelvic floor disorders Urinary incontinence Anal incontinence 

Supplementary material

11695_2013_880_Fig5_ESM.jpg (175 kb)
Appendix 1

Pelvic Floor Distress Inventory—Short Form 20 (JPEG 174 kb)

11695_2013_880_MOESM1_ESM.tif (178 kb)
High Resolution Image (TIFF 178 kb)
11695_2013_880_Fig6_ESM.jpg (251 kb)
Appendix 2

Pelvic Floor Impact Questionnaire—Short Form 7 (JPEG 250 kb)

11695_2013_880_MOESM2_ESM.tif (230 kb)
High Resolution Image (TIFF 229 kb)

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Gitana Scozzari
    • 1
  • Fabrizio Rebecchi
    • 1
  • Claudio Giaccone
    • 1
  • Paolo Chiaro
    • 1
  • Massimiliano Mistrangelo
    • 1
  • Mario Morino
    • 1
  1. 1.Department of Surgical SciencesUniversity of TorinoTurinItaly

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