Bariatric Surgery May Help Urinary Incontinence
Although urinary incontinence (UI) is most common among the elderly, it can effect people of all ages and is an issue for millions of Americans. Women are twice as likely as men to experience urinary incontinence.
UI is the inability to control the flow of urine. Episodes might involve the release of a small amount of urine or to experience a strong and sudden urge that is followed by the release of a large amount of urine. It is not unusual for women to experience both.
Urinary incontinence often occurs after a person laughs, sneezes, coughs, or raises pressure within the abdomen. In the United States the annual health expenditure for addressing UI is around $30 billion.
Obesity and Urinary Incontinence
A number of studies have shown that there is a direct association with being obese or overweight and incontinence. Obesity in an independent risk factor for urinary incontinence and is the most important risk factor compared to any other factor. For each five unit increase in body mass index there is a 60-100 percent increased risk for daily urinary incontinence.
Fat deposits around the abdomen is one of the most important factors connecting obesity and urinary incontinence, and body mass index and an increasing waist-to-hip ratio are also directly associated with urinary incontinence.
The exact pathology that connects obesity and urinary incontinence is a bit foggy. Some studies suggest that excess body weight increases abdominal pressure, which increases bladder pressure and the mobility of the urethra. The result is incontinence.
Bariartic Surgery Improves Urinary Incontinence
It looks like another long-term benefit of bariatric surgery may be improvement in urinary incontinence. In the largest study to date, it was found that severely obese women showed dramatic improvement in urinary incontinence for up to three years after weight loss surgery.
A substudy of 1,565 women with urinary incontinence were drawn from a larger study of bariatric patients. About 7 percent of the women had undergone surgery for urinary incontinence and 8 percent had taken medication for it. The mean age of the women was 46 years old and 86 percent were white. The mean body mass index met the criteria for severe obesity. Prior to surgery, the women filled out a questionnaire in which 22 percent of the women reported weekly episodes of urinary incontinence and 27 percent reported daily episodes.
Following bariatric surgery, weight loss at years one and two was 30 percent and at 29 percent in year three. At year one, the mean number of weekly episodes of urinary incontinence dropped from eleven to three. In year two the number of episodes rose to four but stayed at that number at year three.
Remission was defined as less than weekly episodes of incontinence. Sixty-seven percent of the women reported remission at year one, 60 percent at year two and 59 percent at year three. Complete remission occurred in 29 percent of the women at year one, 27 percent of the women at year two, and 27 percent of the women at year three.
Every 5 percent loss from the baseline translated into a 30 percent greater chance of incontinence improvement.
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