Bariatric surgery may improve urinary incontinence

 

urinary incontinenceBariatric surgery may improve urinary incontinence symptoms in women, according to a study, “Long-term change in urinary incontinence among severely obese women following bariatric surgery,” presented at the American Urogynecologic Society and the International Urogynecological Association 2014 scientific meeting in Washington, DC. The study found that nearly half of women in a weight-loss surgery programme reported having incontinence prior to the procedure. After surgery, most of those women said their urinary symptoms either improved or disappeared.

“The women lost almost 30 percent of their body weight, and about two-thirds who had incontinence at the start were cured at one year with that amount of weight loss,” said study researcher Dr. Leslee Subak, professor of obstetrics, gynecology and reproductive sciences at the University of California San Francisco School of Medicine. “Among those who continued to have incontinence, their incontinence frequency improved a lot.”

Health experts refer to obesity and incontinence as the twin epidemics and it is estimated that 25 to 50 percent of women have urinary incontinence. Of those, 70 percent are obese. The women included in the study were severely obese, with a median BMI 46.

“Both the weight loss and the improvement in incontinence lasted through three years. At year three, about 60 percent had remission,” she said. “Remissions were defined as less than weekly episodes of incontinence. A quarter were completely dry.”

The amount of weight loss was the strongest predictor of whether incontinence would improve or go away, Subak found. Losing more made urinary symptom improvement more likely.

In a previous study, Subak found that a six-month focused programme of weight loss and diet information helped reduce incontinence in obese women better than four weekly education sessions about weight loss and physical activity.

Dr Amy Rosenman, a specialist in urogynecology and pelvic surgery in Santa Monica, CA, and health sciences clinical professor at the University of California Los Angeles David Geffen School of Medicine, said the study findings ring true in practice.

“I have patients who have lost weight and it ended their stress incontinence,” she said. “Those who lost by nonsurgical means also noticed improvement.”

The findings reflect what has been found previously by other researchers, too, said Rosenman, who is president-elect of the American Urogynecologic Society. “There are many other studies that show weight loss improves leakage, probably due to less pressure, less weight pressing on the bladder from above and beside. So it stands to reason that bariatric surgery would also benefit [the incontinence],” she added.

 

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