Effects of bariatric surgery on untreated lower urinary tract symptoms: a prospective multicentre cohort study

Abstract

ObjectiveTo evaluate the effects of bariatric surgery on lower urinary tract symptoms (LUTS) in a prospective cohort study. Patients and MethodsPatients undergoing bariatric surgery were recruited into the study. LUTS were assessed using the International Prostate Symptoms Score (IPSS) in men and Bristol Female Lower Urinary Tract Symptoms Score Questionnaire (BFLUTS) in women. Serum glucose, insulin and prostate-specific antigen (PSA) levels were recorded; insulin resistance was quantified using the Homeostasis Model Assessment (HOMA-IR) method. Patients were assessed before surgery, and at 6-8 weeks and 1 year after surgery. Weight loss, change in body mass index (BMI), total symptoms score as well as individual symptoms were tested for statistical significance with correction for multiple testing using Bonferroni method. Linear regression analysis was performed with total symptoms score change at 1 year as the outcome variable and BMI, age, total symptoms score before surgery, HOMA-IR, glucose level before surgery, insulin level before surgery, change in insulin level after surgery, weight loss and BMI loss as predictor variables. ResultsIn all, 86 patients were recruited and 82% completed at least one follow-up after surgery. There was significant weight loss and reduction of BMI after surgery (P < 0.001). At 6 weeks, there was a significant reduction in overall symptom score (P < 0.001) and this improvement was sustained at 1 year. Linear regression analysis showed that total symptoms score at baseline, HOMA-IR, preoperative insulin level and change in insulin level postoperatively were predictive of the change in total symptoms score while the amount of weight loss was not. ConclusionsThe study confirms the improvement in LUTS after weight loss but there is no correlation between the improvement and the time course or degree of weight loss. Rather there is a suggestion that the improvement in symptoms is linked to improvement in insulin resistance seen as a result of both bariatric surgery and weight loss.

Early Effect of Bariatric Surgery on Urogenital Function in Morbidly Obese Men

“…A recent study looked into the IPSS scores of men at 6 weeks and 1 year following bariatric surgery. They found significant weight loss and improvement in urgency and frequency at 6 weeks 43 . Although we have observed significant improvement in frequency, intermittency, weak stream, nocturia and quality of life in 1 month after the surgery in ED group, the improvement in urgency did not reach significance until 3 months.…”

Age and Obesity Promote Methylation and Suppression of 5α-Reductase 2: Implications for Personalized Therapy of Benign Prostatic Hyperplasia

“…In a prospective multicenter study of 86 patients who underwent bariatric weight loss surgery, there was a significant overall reduction in LUTS at 6 weeks that was sustained at one year after surgery. 29 Several other reports found that healthy dietary quality and increased physical exercise have a protective effect against LUTS. 27, 30 Taken together, these findings suggest that dynamic changes in methylation status may be associated with lifestyle modifications that lead to BPH regression and improvements in LUTS.…”

A Behavioral Weight Loss Program and Nonurinary Incontinence Lower Urinary Tract Symptoms in Overweight and Obese Women with Urinary Incontinence: A Secondary Data Analysis of PRIDE

“…In a cohort study at one year after bariatric surgery,(25) 47 women lost a mean of 37.4 kg and reported a significant improvement in overall Bristol Female Lower Urinary Tract Symptom score (26), nocturia and urgency; however 15% of women had worse scores at 1 year. They found no correlation between improvement and the degree of weight lost, but did observe a correlation between LUTS improvement and insulin resistance improvement.…”