title: Is bariatric surgery the answer to urinary incontinence in obese women?
abstract: To investigate the effect of bariatric surgery on female pelvic floor disorders.
  
  
  
  Eighty consecutive obese women who underwent a laparoscopic sleeve gastrectomy were prospectively enrolled. Four validated questionnaires (ICIQ-UI, BFLUTS-SF, PFDI-20, PISQ-12) were used to evaluate pelvic floor symptoms before and 6 months after surgery. Outcome results were analyzed according to the presence of preoperative urinary incontinence (UI), defined as a positive answer to the question "how often do you leak urine?" on the ICIQ-UI questionnaire.
  
  
  
  Seventy-seven women (age 41.3 ± 11.5 years; parity 1.9 ± 1.6) completed all pre- and postoperative questionnaires. Mean body mass index (BMI) before and 6 months after surgery was 42 ± 4.7 and 33 ± 4.7, respectively. Preoperatively, 29 (37.7%) women (mean age 45.6 ± 11, mean BMI 42.3 ± 5.2) had UI, 17 (59%) of whom had stress urinary incontinence. Surgically induced weight loss was associated with statistically significant improvement in UI and filling symptoms, pelvic organ prolapse and colorectal-anal scores, and condition-specific sexual function and quality of life parameters. Specifically, the total score of the ICIQ-UI questionnaire decreased from 9.28 ± 3.6 preoperatively to 2.9 ± 3.8 postoperatively (P < 0.001), and the urinary score of the PFDI-20 questionnaire decreased from 31.4 ± 17.9 preoperatively to 9.3 ± 12.3 postoperatively (P < 0.001). Furthermore, 15 (51.7%) women reported complete resolution of UI following weight loss.
  
  
  
  Surgically induced weight loss resulted in resolution of UI in up to 52% of preoperatively incontinent women and subsequent improvement in other pelvic floor symptoms. Larger studies with longer follow-up are required to investigate the possible impacts of bariatric surgery on various aspects of pelvic floor function. Neurourol. Urodynam. 36:184-187, 2017. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Surgery, E. Wolfson Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Mordechai
authors.initials: M
authors.lastname: Shimonov
authors.affiliation: Urogynecology and Pelvic Floor Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Asnat
authors.initials: A
authors.lastname: Groutz
authors.affiliation: Department of Surgery, E. Wolfson Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Pinhas
authors.initials: P
authors.lastname: Schachter
authors.affiliation: Urogynecology and Pelvic Floor Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Gordon
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000601:surgery*; D059952:Pelvic Floor Disorders / Q000150:complications* / Q000601:surgery*; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000150:complications; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000150:complications* / Q000601:surgery*; D015431:Weight Loss; D055815:Young Adult
keywords: bariatric surgery; lower urinary tract symptoms; quality of life; urinary incontinence; weight loss