title: Effects of bariatric surgery on urinary and sexual function.
abstract: OBJECTIVE
  To investigate the effects of weight loss and time post laparoscopic gastric banding surgery (LGB) on urinary and sexual function.
  
  
  METHODS
  653 females and 145 males who underwent LGB over the last 10 years at a single centre in Australia were contacted by post and asked to complete validated questionnaires.
  
  
  RESULTS
  The pre-surgery body-mass index (BMI) was higher in males than females (47.3 vs 43.5); 65% of the females and 24% of males previously had some degree of urinary incontinence (UI). There were significant weight and BMI losses in males and females (23.2 kg and 7.51 vs 22.7 kg and 8.28; P < 0.0001). In females there were significant improvements in the ICIQ-SF (P= 0.0008) and Quality of Life (P < 0.0001) scores. For each kilogram lost there was a 0.05 improvement in the ICIQ score (P= 0.03) in females. There were also postoperative improvements in all symptoms of UI and stress incontinence in females but urge incontinence worsened, when adjusted for weight loss. In males there was no improvement in UI with weight loss after LGB. There was no relationship with time and UI in either gender; 83.3% of males reported a degree of ED before LGB. There was improvement in the IIEF score in males post LGB but there was worsening of erectile index (P= 0.005) and orgasmic function (P= 0.002) when adjusted for time. More males had started using phosphodiesterase type 5 inhibitors, post-LGB.
  
  
  CONCLUSIONS
  Surgically induced weight loss by LGB improved overall UI, quality of life and stress incontinence in females but urge incontinence worsened. There was no improvement in UI with weight-loss or overall sexual function after LGB in males. However, erectile index and orgasmic function worsened when adjusted for time. Further evaluation is required by means of larger prospective studies involving urodynamic testing.
authors: Austin Hospital, Melbourne, Victoria, Australia. weranja@gmail.com
authors: Weranja K B
authors: WK
authors: Ranasinghe
authors: Timothy
authors: T
authors: Wright
authors: John
authors: J
authors: Attia
authors: Patrick
authors: P
authors: McElduff
authors: Terrence
authors: T
authors: Doyle
authors: Meegan
authors: M
authors: Bartholomew
authors: Katrina
authors: K
authors: Hurley
authors: Rajendra A
authors: RA
authors: Persad
mesh_terms: D015992:Body Mass Index; D004812:Epidemiologic Methods; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology*; D015431:Weight Loss