title: Does bariatric surgery affect urinary incontinence?
abstract: OBJECTIVE
  To determine International Classification of Disease, 9th Revision, (ICD-9) coding patterns as a proxy for incidence and prevalence of urinary incontinence (UI) in a population of patients before and after a bariatric surgical procedure for the treatment of obesity.
  
  
  METHODS
  We evaluated claims from a national private insurer over a 5-year period (2002-2006) to identify female patients who underwent bariatric surgery and had 3 years of follow-up claims data. The cohort of patients who underwent bariatric surgery (treatment) was matched to a cohort of obese female patients who did not undergo bariatric surgery (control), who were followed from the start of their enrollment. UI was identified by ICD-9 coding.
  
  
  RESULTS
  After bariatric surgery, 62.4% of patients (83/133) diagnosed with UI before their surgery no longer had a coding diagnosis of UI. In contrast, only 42.1% (56/133) of those in the nonbariatric surgery cohort lost their coding diagnosis of UI (P = .0009). Of those that did not have pre-existing UI, 6.2% (235/3765) of the bariatric surgery cohort gained a new coding diagnosis of UI vs 7.1% (269/3765) of the control group (P = .1169). Our final model suggested that age >45 years (P <.0001) and pre-existing UI (P <.0001) were significantly associated with post-index date UI. Interaction between bariatric surgical status and UI was also significant (P <.0001).
  
  
  CONCLUSIONS
  Patients who undergo bariatric surgery are more likely to lose a previous diagnosis of UI than are obese patients not treated with bariatric surgery. This supports the fact that bariatric surgery may have other indirect benefits to the obese population.
authors.affiliation: Department of Obstetrics and Gynecology, Ochsner Medical Center, New Orleans, LA, USA. lknoepp@gmail.com
authors.forename: Leise R
authors.initials: LR
authors.lastname: Knoepp
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Semins
authors.forename: E James
authors.initials: EJ
authors.lastname: Wright
authors.forename: Kimberly
authors.initials: K
authors.lastname: Steele
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Shore
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Clark
authors.forename: Martin A
authors.initials: MA
authors.lastname: Makary
authors.forename: Brian R
authors.initials: BR
authors.lastname: Matlaga
authors.forename: Chi Chiung Grace
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D050110:Bariatric Surgery / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery*; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D015431:Weight Loss