Effect of bariatric surgery on urinary and fecal incontinence: prospective analysis with 1-year follow-up

Said, Khelifa Ait; Leroux, Yannick; Menahem, Benjamin; Doerfler, A.; Alvès, Arnaud; Tillou, X.

doi:10.1016/j.soard.2016.08.019

Cited by 26 publications

(13 citation statements)

References 19 publications

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“…From 817 potentially relevant reports, 35 studies (all observational; no randomised trials) were eligible . Of these 35, we excluded two studies in this systematic review: Shimonov et al.…”

Section: Resultsmentioning

confidence: 99%

“…Table presents descriptions of the 33 included studies . Table provides each authors’ definition of SUI and UUI, and descriptions of validated questionnaires used to assess UI . A wide range of 14 different UI questionnaires were used across included studies (complete list of UI questionnaires is available in Table S3).…”

Section: Resultsmentioning

confidence: 99%

“…Bariatric surgery is the most effective form of sustained weight loss in patients with obesity . Earlier studies have also reported a decreased prevalence of UI in obese patients, even years after bariatric surgery . Despite the increasing evidence investigating the effect of bariatric surgery on UI, no quantitative synthesis exists.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the increasing evidence investigating the effect of bariatric surgery on UI, no quantitative synthesis exists. Unfortunately, studies commonly use a wide range of questionnaires and outcome measures to evaluate UI, making comparisons difficult and complicating the assessment of bariatric surgery on specific types of UI .…”

Section: Introductionmentioning

confidence: 99%

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The impact of bariatric surgery on urinary incontinence: a systematic review and meta‐analysis

Lee

Tikkinen

et al. 2019

BJU International

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ObjectivesTo systematically review and meta-analyse the impact of bariatric surgery on obese patients with urinary incontinence (UI). MethodsA search of the Medical Literature Analysis and Retrieval System Online (MEDLINE), the Excerpta Medica dataBASE (EMBASE), Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and PubMed to June 2018 was performed using methods pre-published on the International Prospective Register of Systematic Reviews (PROSPERO). Reporting followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Studies comparing UI status in obese patients before and after bariatric surgery were included. Primary outcomes were the improvement or complete resolution of any UI, stress UI (SUI), and urgency UI (UUI). Secondary outcomes were validated UI questionnaire scores. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach assessed overall quality of evidence. ResultsIn all, 33 cohort studies (2910 patients) were included (median follow-up 12 months). Bariatric surgery resulted in improvement or resolution of any UI in 56% (95% confidence interval [CI] 48-63%), SUI in 47% (95% CI 34-60%), and UUI in 53% (95% CI 32-73%) of patients. Moreover, bariatric surgery significantly decreased (P < 0.001) questionnaire scores such as: the Urogenital Distress Inventory by 13.4 points (95% CI 7.2-19.6), International Consultation on Incontinence Questionnaire by 4.0 points (95% CI 2.3-5.7), and Incontinence Impact Questionnaire by 5.3 points (95% CI 3.9-6.6). However, worsening or new onset of UI was present in 3% of patients. The quality of evidence was very low for all outcomes. ConclusionHalf of obese patients report improvement or resolution of UI after bariatric surgery, but overall the quality of evidence is very low. Comparative studies examining the benefits of bariatric surgery in obese patients with UI are warranted.Keywords bariatric surgery, obesity, urinary incontinence, stress urinary incontinence, urge urinary incontinence, #Incontinence

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“…From 817 potentially relevant reports, 35 studies (all observational; no randomised trials) were eligible . Of these 35, we excluded two studies in this systematic review: Shimonov et al.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The impact of bariatric surgery on urinary incontinence: a systematic review and meta‐analysis

Lee

Tikkinen

et al. 2019

BJU International

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“…It was shown that after bariatric surgery, there were significant improvements in voiding status assessed by voiding questionnaires [ 5 ], as well as in objective tests such as pad test [ 6 ]. Additionally, it was confirmed that weight loss after surgery improves various lower urinary tract symptoms such as stress urinary incontinence, urge incontinence, and dysuria, as well as quality of life in the above aspect [ 7 ]. It was also shown on the basis of patients’ questionnaires that bariatric surgery improves different symptoms related to pelvic floor disorders connected with POP (prolapse, lower urinary tract, colorectal symptoms, and sexual dysfunctions) [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?

et al. 2017

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IntroductionObesity is one of the well-documented risk factors of pelvic floor disorders (PFDs). The PFDs include urinary and fecal incontinence (UI, FI) and pelvic organ prolapse (POP). Surgery-induced weight loss improves different kinds of incontinence as well as POP symptoms. However, there is a lack of evidence how bariatric surgery influences pelvic floor anatomy and function in women without previous PFDs and whether it may be concerned as PFD prophylaxis tool.Materials and MethodsThe present analysis is a prospective, non-randomized case-control study from January 2014 to September 2017. Participants underwent pelvic floor ultrasound examination with bladder neck position estimation at rest, during levator ani tension, and at Valsalva maneuver before surgery and 12–18 months after. Pelvic organ prolapse quantification (POPQ) > 2 stage and PFD complaints were the exclusion criteria.ResultsFifty-nine patients underwent bariatric surgery (57 sleeve gastrectomy and 2 gastric bypass). Mean BMI decreased from 43.8 ± 5.9 to 29 ± 4.6 kg/m2 after surgery (p < 0.001). Statistically significant higher position of the bladder neck at rest, during tension, and at Valsalva maneuver (p < 0.05) was shown after surgery. We did not demonstrate differences in bladder neck mobility and bladder neck elevation at tension after weight loss.ConclusionsBariatric surgery is associated with a betterment of bladder neck position at rest, tension, and Valsalva maneuver in women without PFDs. We postulate that bariatric surgery may be a tool for PFD prevention. It does not improve levator ani function and does not limit bladder neck mobility, which implicates that it has no influence on preexisting pelvic dysfunction.

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Behavioral Therapy and Lifestyle Modifications for the Management of Urinary Incontinence in Women

Kenne

Bradley

2022

Female Urinary Incontinence

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Effect of bariatric surgery on urinary and fecal incontinence: prospective analysis with 1-year follow-up

Cited by 26 publications

References 19 publications

The impact of bariatric surgery on urinary incontinence: a systematic review and meta‐analysis

The impact of bariatric surgery on urinary incontinence: a systematic review and meta‐analysis

Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?

Behavioral Therapy and Lifestyle Modifications for the Management of Urinary Incontinence in Women

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