Advertisement

Obesity Surgery

, Volume 29, Issue 1, pp 109–113 | Cite as

Urinary Incontinence and Surgery for Obesity and Weight-Related Diseases: Are There Predictors of Improvement?

  • Christiana Campani NygaardEmail author
  • Lucas Schreiner
  • Thiago Picolli Morsch
  • Rodrigo Petersen Saadi
  • Marina Faria Figueiredo
  • Alexandre Vontobel Padoin
Original Contributions
  • 69 Downloads

Abstract

Purpose

The aim of this study was to evaluate changes in urinary incontinence (UI) before and after surgery for obesity in female patients and to identify factors related to the remission of symptoms.

Materials and Methods

This was a prospective cohort study with female patients over 18 years old who underwent surgery for obesity and weight-related diseases between June 2016 and September 2017. Urinary symptoms and quality of life related to UI were assessed based on a structured interview and the results of the validated questionnaires.

Results

Two hundred twenty-one patients were assessed pre-operatively, and 118 (53.3%) reported UI. Eighty-eight patients (74.6%) completed the pre- and postoperative questionnaires. After 6 to 12 months, patients were revaluated, and 50 (56.8%) were considered to be in remission of urinary symptoms. Women who had only a cesarean birth had a 117% increase in the probability of achieving remission of UI compared with women who had both vaginal and cesarean deliveries, and patients with an additional point in the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score at the beginning had a 4% lower probability of having remission of symptoms.

Conclusions

Improvement in UI may be an important outcome of surgery for obesity and weight-related diseases. In this study, previous cesarean section was only associated with the highest rate of remission of symptoms, and patients with higher scores in the ICIQ-UI-SF had a lower probability of remission.

Keywords

Urinary incontinence Surgery for obesity Quality of life 

Notes

Acknowledgements

This work was conducted during a scholarship supported by CAPES (Brazilian Federal Agency for Support and Evaluation of Graduate Education within the Ministry of Education of Brazil.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest..

Statements Regarding Ethics and Consent

An informed consent form was offered to patients who satisfied the study criteria. Ethics and research approvals were obtained from the applicable local committees.

Justification Statement

Only women were enrolled in the study to avoid bias related to gender.

Ethics

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Deitel M. Overweight and obesity worldwide now estimated to involve 1.7 billion people. Obes Surg. 2003;13(3):329–30.CrossRefGoogle Scholar
  2. 2.
    Ul-Haq Z, Mackay DF, Fenwick E, et al. Meta-analysis of the association between body mass index and health-related quality of life among adults, assessed by the SF-36. Obesity (Silver Spring). 2013;21(3):E322–7.CrossRefGoogle Scholar
  3. 3.
    Dumon K, Savulionyte G. Bariatric surgery produces greater weight loss and improvements in medical conditions than non-surgical treatment of obesity. Evid Based Med. 2014;19(4):138.CrossRefGoogle Scholar
  4. 4.
    Courcoulas AP, King WC, Belle SH, et al. Seven-year weight trajectories and health outcomes in the longitudinal assessment of bariatric surgery (LABS) study. JAMA Surg. 2018;153(5):427–34.CrossRefGoogle Scholar
  5. 5.
    Karmali S, Kadikoy H, Brandt ML, et al. What is my goal? Expected weight loss and comorbidity outcomes among bariatric surgery patients. Obes Surg. 2011;21(5):595–603.CrossRefGoogle Scholar
  6. 6.
    Ahroni JH, Montgomery KF, Watkins BM. Laparoscopic adjustable gastric banding: weight loss, co-morbidities, medication usage and quality of life at one year. Obes Surg. 2005;15(5):641–7.CrossRefGoogle Scholar
  7. 7.
    Subak LL, Richter HE, Hunskaar S. Obesity and urinary incontinence: epidemiology and clinical research update. J Urol. 2009;182(6 Suppl):S2–7.CrossRefGoogle Scholar
  8. 8.
    Hunskaar S. A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women. Neurourol Urodyn. 2008;27(8):749–57.CrossRefGoogle Scholar
  9. 9.
    Swenson CW, Kolenic GE, Trowbridge ER, et al. Obesity and stress urinary incontinence in women: compromised continence mechanism or excess bladder pressure during cough? Int Urogynecol J. 2017;28(9):1377–85.CrossRefGoogle Scholar
  10. 10.
    Richter HE, Creasman JM, Myers DL, et al. Urodynamic characterization of obese women with urinary incontinence undergoing a weight loss program: the program to reduce incontinence by diet and exercise (PRIDE) trial. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(12):1653–8.CrossRefGoogle Scholar
  11. 11.
    Tamanini JT et al. Validation of the “International Consultation on Incontinence Questionnaire-Short Form” (ICIQ-SF) for Portuguese. Rev Saude Publica. 2004;38(3):438–44.CrossRefGoogle Scholar
  12. 12.
    Tamanini JT et al. Validation of the Portuguese version of the King’s Health Questionnaire for urinary incontinent women. Rev Saude Publica. 2003;37(2):203–11.CrossRefGoogle Scholar
  13. 13.
    Haylen BT, Freeman RM, Swift SE, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) & grafts in female pelvic floor surgery. Int Urogynecol J. 2011;22(1):3–15.CrossRefGoogle Scholar
  14. 14.
    Subak LL, King WC, Belle SH, et al. Urinary incontinence before and after bariatric surgery. JAMA Intern Med. 2015;175(8):1378–87.CrossRefGoogle Scholar
  15. 15.
    Burgio KL, Richter HE, Clements RH, et al. Changes in urinary and fecal incontinence symptoms with weight loss surgery in morbidly obese women. Obstet Gynecol. 2007;110(5):1034–40.CrossRefGoogle Scholar
  16. 16.
    O’Boyle CJ et al. The effect of bariatric surgery on urinary incontinence in women. Obes Surg. 2016;26(7):1471–8.CrossRefGoogle Scholar
  17. 17.
    Lian W, Zheng Y, Huang H, et al. Effects of bariatric surgery on pelvic floor disorders in obese women: a meta-analysis. Arch Gynecol Obstet. 2017;296(2):181–9.CrossRefGoogle Scholar
  18. 18.
    Rortveit G, Hannestad YS, Daltveit AK, et al. Age- and type-dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study. Obstet Gynecol. 2001;98(6):1004–10.Google Scholar
  19. 19.
    Lukacz ES, Lawrence JM, Contreras R, et al. Parity, mode of delivery, and pelvic floor disorders. Obstet Gynecol. 2006;107(6):1253–60.CrossRefGoogle Scholar
  20. 20.
    Volloyhaug I et al. Pelvic organ prolapse and incontinence 15-23 years after first delivery: a cross-sectional study. BJOG. 2015;122(7):964–71.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Christiana Campani Nygaard
    • 1
    Email author return OK on get
  • Lucas Schreiner
    • 2
  • Thiago Picolli Morsch
    • 2
  • Rodrigo Petersen Saadi
    • 2
  • Marina Faria Figueiredo
    • 2
  • Alexandre Vontobel Padoin
    • 1
  1. 1.Graduate Program in Medicine and Health SciencesPUCRSPorto AlegreBrazil
  2. 2.Pontifícia Universidade Católica do Rio Grande do SulPorto AlegreBrazil

Personalised recommendations