From the Department of Physical Therapy, Universidade de Cruz Alta, RS, Brazil.
Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Catania, Italy.
Female Pelvic Med Reconstr Surg. 2020 Nov;26(11):e62-e67. doi: 10.1097/SPV.0000000000000757.
Obese women with large abdominal volume may present with elevated intra-abdominal and intravesical pressure due to their high body mass index (BMI), which leads to an imbalance in the mechanism responsible for urinary continence. Thus, these women have a 2-fold chance of developing urinary incontinence (UI) than nonobese women. Because increased BMI represents a risk factor for UI development, we hypothesize that its reduction could alleviate or decrease the symptoms of this condition in obese women. Therefore, the aim of this study was to describe the impact of weight loss on the severity of UI symptoms and quality of life (QoL) in women undergoing bariatric surgery.
This was a combined case-cohort study lasting 1 year, with 26 obese women aged 18 to 59 years who underwent bariatric surgery and presented preoperative UI. The participants' BMI was calculated, their UI was assessed through the International Consultation on Incontinence Questionnaire-Short Form, and QoL by the King's Health Questionnaire. Reassessments were performed at 3, 6, 9, and 12 postoperative months.
We found no significant association between BMI reduction and prevalence and severity of UI. However, the 8-point reduction in BMI was sufficient to decrease the severity of UI. Quality of life improved significantly in 7 of the 9 domains evaluated.
According to the results of our study, we can conclude that the reduction in the prevalence and severity of UI together with weight loss induced by bariatric surgery was more evident in the first 3 months postoperatively, impacting positively the QoL of these women.
肥胖女性由于体重指数（BMI）较高，腹部体积较大，可能会导致腹腔内和膀胱内压力升高，从而导致控制尿失禁的机制失衡。因此，这些女性发生尿失禁（UI）的几率是正常体重女性的两倍。由于 BMI 升高是发生 UI 的危险因素，我们假设降低 BMI 可能会减轻或减少肥胖女性的这种疾病症状。因此，本研究旨在描述减肥对接受减重手术的肥胖女性 UI 症状严重程度和生活质量（QoL）的影响。
这是一项为期 1 年的病例对照联合研究，纳入了 26 名年龄在 18 至 59 岁之间的肥胖女性，这些女性在接受减重手术前患有 UI。计算参与者的 BMI，通过国际尿失禁咨询问卷-短期形式评估 UI，通过 King's 健康问卷评估 QoL。在术后 3、6、9 和 12 个月进行重新评估。
我们发现 BMI 降低与 UI 的患病率和严重程度之间没有显著关联。然而，BMI 降低 8 个点足以降低 UI 的严重程度。在评估的 9 个领域中的 7 个领域中，QoL 显著改善。
根据我们的研究结果，我们可以得出结论，与减肥手术引起的体重减轻一起，UI 的患病率和严重程度的降低在术后前 3 个月更为明显，对这些女性的 QoL 产生积极影响。
