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Impact of bariatric surgery on urinary incontinence in morbidly obese individuals

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Abstract

Background

There is scanty evidence on the impact of bariatric surgery on urinary incontinence (UI) in the Asian population.

Methodology

Patients who underwent bariatric surgery from June 2018 to June 2019 were screened using the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) questionnaire. Patients having UI were identified and followed until 1 year of surgery using the ICIQ-UI-SF. These were classified as having stress, urge, or mixed type of UI. The prevalence, change in scores, and the number of pads used were compared at baseline and at follow-up.

Results

A total of 148 patients underwent bariatric surgery of whom, 41 patients (M = 2, F = 39) had UI. Stress incontinence was seen in 70.7%, 19.5% had urge incontinence, and rest had the mixed type. Using logistic regression, it was found that female gender was the most important predictor of having UI (OR: 8.33). The prevalence of UI decreased from 27.7% at baseline to 8.1% at 6 months and 3.4% at 12 months. The mean ICIQ-UI-SF score improved from 8.76 (SD = 3.2) at baseline to 0.66 (SD = 2.1) at 12 months of follow-up. The proportion of patients with UI using any number of pads decreased from 92.7% at baseline to 9.8% at 12 months. There was a decrease in the number of patients having moderate to very severe UI from 35 (85.4%) at baseline to 2 (4.9%) at 12 months. Proportion of patients showing resolution was highest among the stress incontinence group at 96.5%. Presence or absence of comorbidities did not significantly influence the ICIQ-UI-SF scores.

Conclusion

Bariatric surgery leads to profound improvement in UI in obese individuals which is well sustained until 1 year of follow-up. Resolution rates might be higher in Asian population.

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Acknowledgements

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Authors and Affiliations

  1. Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Prasanna Ramana Arumugaswamy, Vitish Singla & Sandeep Aggarwal

  2. Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Prabhjot Singh & Rajeev Kumar

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  1. Prasanna Ramana Arumugaswamy
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  2. Vitish Singla
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  3. Prabhjot Singh
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  4. Rajeev Kumar
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  5. Sandeep Aggarwal
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Correspondence to Sandeep Aggarwal.

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Disclosure

Prasanna Ramana Arumugaswamy, Vitish Singla, Prabhjot Singh, Rajeev Kumar, and Sandeep Aggarwal have declared that they have no conflicts of interest or financial ties to disclose.

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A formal ethical clearance was taken before the start of this study (IECPG-263/28.06.2018).

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Presentation in conferences: Interim results were presented as an e-poster in 28th EAES International congress | 24–26 June 2020 and its abstract published in the online version of Surgical Endoscopy, September 2020 issue 1.

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Arumugaswamy, P.R., Singla, V., Singh, P. et al. Impact of bariatric surgery on urinary incontinence in morbidly obese individuals. Surg Endosc 36, 4771–4779 (2022). https://doi.org/10.1007/s00464-021-08818-y

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