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减肥手术对尿失禁的影响。

Effects of bariatric surgery on urinary incontinence.

作者信息

Bulbuller Nurullah, Habibi Mani, Yuksel Mustafa, Ozener Onur, Oruc Mehmet Tahir, Oner Osman Zekai, Kazak Mehmet Altug

机构信息

General Surgery Department, Antalya Training and Research Hospital, Antalya.

General Surgery Department, Antalya Training and Research Hospital, Antalya; General Surgery Department, Esenler Maternity and Child Health Hospital, Istanbul.

出版信息

Ther Clin Risk Manag. 2017 Jan 19;13:95-100. doi: 10.2147/TCRM.S125781. eCollection 2017.

Abstract

INTRODUCTION

Obesity is an important modifiable etiological factor associated with several diseases. There is strong evidence that urinary incontinence (UI) is positively correlated with body mass index (BMI).

AIM

One of the many benefits experienced by obese patients after bariatric surgery is decrease in UI. To investigate this correlation, we aimed to examine the effects of weight loss on UI in female patients who had undergone laparoscopic sleeve gastrectomy (LSG).

MATERIALS AND METHODS

Obese female patients (n=120), ≥18 years of age, and planning to undergo LSG were included in this prospective study. We administered the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) and Incontinence Impact Questionnaire (IIQ-7) to the patients prior to surgery and 6 months after the surgery. Using the collected data, we determined the incidence of UI and examined the relationship between the preoperative and postoperative BMI and UI values.

RESULTS

The mean age of the patients was 39.19 (standard deviation [SD] =9.94) years and the mean preoperative BMI was 46.17 (SD =5.35). Of the 120 patients, 72 (60%) complained of UI preoperatively. Among these 72 patients, 23 (31.95%) described urge incontinence, 18 (25%) stress incontinence, and 31 (43.05%) mixed-type incontinence. At 6 months postoperatively, the percentage of excess weight loss was 70.33% (SD =14.84%). For all three UI subtypes, the 6-month postoperative ICIQ-UI-SF and IIQ-7 scores decreased significantly compared to the preoperative scores (<0.05).

CONCLUSION

LSG results in a clinically significant improvement in most common types of UI, regardless of patient reproductive history, existence of comorbid conditions, and smoking status.

摘要

引言

肥胖是与多种疾病相关的一个重要的可改变病因因素。有强有力的证据表明尿失禁(UI)与体重指数(BMI)呈正相关。

目的

肥胖患者在减重手术后体验到的众多益处之一是尿失禁减少。为了研究这种相关性,我们旨在检查体重减轻对接受腹腔镜袖状胃切除术(LSG)的女性患者尿失禁的影响。

材料与方法

本前瞻性研究纳入了年龄≥18岁且计划接受LSG的肥胖女性患者(n = 120)。我们在手术前和手术后6个月对患者进行国际尿失禁咨询问卷-尿失禁-简表(ICIQ-UI-SF)和尿失禁影响问卷(IIQ-7)的评估。利用收集到的数据,我们确定了尿失禁的发生率,并检查了术前和术后BMI与尿失禁值之间的关系。

结果

患者的平均年龄为39.19岁(标准差[SD]=9.94),术前平均BMI为46.17(SD = 5.35)。120例患者中,72例(60%)术前主诉有尿失禁。在这72例患者中,23例(31.95%)为急迫性尿失禁,18例(25%)为压力性尿失禁,31例(43.05%)为混合型尿失禁。术后6个月,超重减轻百分比为70.33%(SD = 14.84%)。对于所有三种尿失禁亚型,术后6个月的ICIQ-UI-SF和IIQ-7评分与术前评分相比均显著降低(<0.05)。

结论

无论患者的生育史、合并症情况和吸烟状况如何,腹腔镜袖状胃切除术均可使最常见类型的尿失禁在临床上得到显著改善。

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