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Urinary incontinence affects almost all severely obese women and a substantial proportion of severely obese men. Prevalence of incontinence drops significantly during the first year after bariatric surgery (NEJM JW Gen Med Dec 15 2007 and Obstet Gynecol 2007 Nov; 110:1034), but long-term benefit is unclear. In this multisite U.S. study, investigators assessed urinary incontinence before and after bariatric surgery in 2458 patients (median ages, 46 in women and 50 in men; median body-mass index, 46 kg/m2) who were followed for 3 years. Most patients underwent either Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding.
During 3 years, mean weight loss was about 30% among women and 26% among men. Prevalence of any type of urinary incontinence (frequency, ≥1 episode weekly) at 3 years was significantly lower than at baseline: 24% versus 49% in women, and 13% versus 22% in men. Prevalence was lowest at 1 year (18% and 10%, respectively) but climbed slightly during the next 2 years. The likelihood of incontinence remission and improvement in symptoms correlated with degree of weight loss.
Subak LL et al. Urinary incontinence before and after bariatric surgery. JAMA Intern Med 2015 Jun 22; [e-pub]. (http://dx.doi.org/10.1001/jamainternmed.2015.2609)
Comment
These positive and generally expected results confirm that persistence of weight loss during 3 years following bariatric surgery is associated with lower prevalence of incontinence.