Effect of laparoscopic gastric bypass surgery on urinary incontinence in morbidly obese women.

摘要

BACKGROUND: Morbid obesity is an independent risk factor for urinary incontinence (UI) that tends to be underreported. A validated, reliable, self-administered, easy-to-use questionnaire was used to determine the effect of laparoscopic gastric bypass (LGB) surgery on UI in morbidly obese women. METHODS: We prospectively evaluated 470 morbidly obese women seeking bariatric surgery with the International Consultation on Incontinence Questionnaire Short Form. The International Consultation on Incontinence Questionnaire Short Form was given to female patients at their initial consultation and at 3 and 12 months after LGB to assess both UI symptoms and quality of life. Data are expressed as the mean +/- standard deviation. RESULTS: The preoperative prevalence of UI was 66% (n = 309) and included 21% urge, 33% stress, and 46% mixed UI. For the 58 patients with UI who underwent LGB and completed a follow-up International Consultation on Incontinence Questionnaire Short Form, a reduction occurred in the total symptom score from 7.6 +/- 4 preoperatively to 3.0 +/- 4 and 1.8 +/- 4 (P < .001) at 3 and 12 months after LGB, respectively. The corresponding quality-of-life scores improved from 3.2 +/- 3 to 1.0 +/- 2 and 0.4 +/- 2 (P < .001). The UI had resolved in 64% and improved overall in 92% of patients at 1 year after LGB. An improvement in UI was found within 3 months after LGB with as little as 30 lb of weight loss. CONCLUSION: UI is a common co-morbidity in the morbidly obese and was prevalent in two thirds of female patients presenting for bariatric surgery evaluation. LGB with resultant weight loss significantly improved the UI symptoms and quality of life.