From the Departments of Urology.
Gynecology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Female Pelvic Med Reconstr Surg. 2020 Mar;26(3):207-211. doi: 10.1097/SPV.0000000000000631.
The aim of this study was to explore the effectiveness of bariatric surgery in obese women with urinary incontinence (UI) through meta-analysis.
Searches of PubMed, the Cochrane Library, and EMBASE databases were performed using "weight loss surgery/bariatric surgery/gastric bypass surgery" and "incontinentia urinae/uracratia/urinary incontinence/uroclepsia" in the title/abstract before January 2018. Then, meta-analysis was analyzed by Review Manager 5.3 (Cochrane Collaboration, Oxford, United Kingdom). The standardized mean difference (SMD) and odds ratio (OR) were used to describe results of continuous variables and dichotomous variables, respectively.
Pooled data showed that bariatric surgery reduced the incidence of UI in obese women at the follow-up of 6 months (OR, 3.27; 95% confidence interval [CI], 2.55-4.21; P < 0.00001) and 12 months (OR, 4.04; 95% CI, 2.62-6.22; P < 0.00001) and significantly reduced the body mass index at 6 months (SMD, 1.86; 95% CI, 1.19-2.53; P < 0.00001) and 12 months (SMD, 2.04; 95% CI, 1.44-2.64; P < 0.00001). In addition, bariatric surgery could also significantly increase the quality of life (SMD, 0.53; 95% CI, 0.27-0.80; P < 0.00001) and improve the function of pelvic floor disorders (SMD, 0.55; 95% CI, 0.38-0.72; P < 0.00001) based on quality-of-life questionnaires and Pelvic Floor Distress Inventory 20, respectively.
This meta-analysis demonstrated that bariatric surgery is an effective choice for obese women with UI. However, more randomized controlled trials are required to confirm this result.
本研究旨在通过荟萃分析探讨减重手术治疗肥胖型尿失禁（UI）患者的有效性。
检索 2018 年 1 月前在 PubMed、Cochrane 图书馆和 EMBASE 数据库中以“weight loss surgery/bariatric surgery/gastric bypass surgery”和“incontinentia urinae/uracratia/urinary incontinence/uroclepsia”为题/摘要进行的研究，采用 Review Manager 5.3（Cochrane 协作网，英国牛津）进行荟萃分析。采用标准化均数差（SMD）和比值比（OR）分别描述连续性变量和二分类变量的结果。
汇总数据显示，与术前相比，减重手术后肥胖型 UI 患者的 UI 发生率在术后 6 个月（OR 3.27，95%CI 2.554.21，P＜0.00001）和 12 个月（OR 4.04，95%CI 2.626.22，P＜0.00001）时显著降低，同时术后 6 个月（SMD 1.86，95%CI 1.192.53，P＜0.00001）和 12 个月（SMD 2.04，95%CI 1.442.64，P＜0.00001）的 BMI 也显著降低。此外，基于生活质量问卷和盆腔器官脱垂/尿失禁性功能问卷，减重手术还可显著提高患者的生活质量（SMD 0.53，95%CI 0.270.80，P＜0.00001）和盆底功能障碍（SMD 0.55，95%CI 0.380.72，P＜0.00001）。
该荟萃分析表明，减重手术是肥胖型 UI 患者的有效治疗选择，但还需要更多的随机对照试验来证实这一结果。
