Prospective evaluation of urinary incontinence in severely obese adolescents presenting for weight loss surgery.

BACKGROUND

Obesity has been associated with daytime urinary incontinence (UI), likely due to increased intra-abdominal pressure.

OBJECTIVES

To assess incontinence symptoms in severely obese adolescents before and 3 years after bariatric surgery.

SETTING

Tertiary care pediatric hospitals in the United States.

METHODS

The Teen-Longitudinal Assessment of Bariatric Surgery is a prospective, multicenter study designed to evaluate efficacy and safety of bariatric surgery in adolescents. Patients<19 years of age undergoing bariatric surgery at 5 centers between 2007 and 2012 were enrolled. Trained study staff collected baseline and postoperative anthropometric and clinical data. Presence and severity of UI were determined by standardized interview.

RESULTS

A total of 242 patients (76% female) were evaluated at baseline. The mean age was 17.1 years at baseline, and 72% were of white race. The preoperative median body mass index was 50.5 kg/m. At baseline, 18% of females and 7% of males reported UI. Prediction analysis at baseline indicated that females, white race, and increasing body mass index had greater odds for UI. UI prevalence in females and males decreased to 7% and 0%, respectively, at 6 months after surgery (P<.01) and remained stable out to 36 months postoperatively. Furthermore, older patients were less likely to achieve 3-year UI remission or improvement.

CONCLUSIONS

In adolescents undergoing bariatric surgery, UI was more common in females than in males. Incontinence status significantly improved by 6 months and was durable to 3 years after surgery, suggesting that bariatric surgery favorably affects anatomic or physiologic mechanisms of bladder control in both males and females.