Faculdade de Medicina do ABC, Santo André, SP, Brazil.
Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2021 Mar 15;19:eAO5701. doi: 10.31744/einstein_journal/2021AO5701. eCollection 2021.
To examine epidemiologic, anthropometric and clinical variables associated with stress urinary incontinence in obese women, before and after bariatric surgery, and to identify predictive factors of stress urinary incontinence resolution.
Prospective observational study with women enrolled in a bariatric surgery program between 2015 and 2016. Patients were assessed prior to and 6 months after bariatric surgery using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Patient Global Impression of Improvement and the Visual Analogue Scale. Patient assessment also included physical examination and bladder stress tests.
A total of 43 women completed the study. There was a 72.7% reduction in stress urinary incontinence (p=0.021). Predictive factors for preoperative diagnosis of stress urinary incontinence included age (p=0.024) and abdominal waist circumference (p=0.048). Urinary symptoms improved after weight loss, especially nocturia (p=0.001) and stress urinary incontinence (p=0.026). Menopause was the most significant predictive factor for persistence of stress urinary incontinence within six months of bariatric surgery (p=0.046). Self-reported outcomes and scores obtained in the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Patient Global Impression of Improvement and the Visual Analogue Scale were associated with significant improvement (p=0.012, p=0.025, and p=0.002 respectively).
Older women with larger waist circumference have a higher risk of developing stress urinary incontinence prior to bariatric surgery. Menopausal women are highly prone to persistent stress urinary incontinence, even after weight loss. Weight loss achieved through bariatric surgery improved stress urinary incontinence symptoms and mitigated related impacts on quality of life in the vast majority of women.
研究肥胖女性接受减重手术后发生压力性尿失禁的流行病学、人体测量学和临床相关因素，并确定压力性尿失禁缓解的预测因素。
本研究为前瞻性观察研究，纳入 2015 年至 2016 年期间参加减重手术项目的女性患者。患者在减重手术前和术后 6 个月分别采用国际尿失禁咨询问卷尿失禁简表、患者总体印象改善量表和视觉模拟量表进行评估。患者评估还包括体格检查和膀胱压力测试。
共有 43 名女性完成了研究。压力性尿失禁的发生率降低了 72.7%（p=0.021）。术前压力性尿失禁的预测因素包括年龄（p=0.024）和腹部腰围（p=0.048）。减肥后，尿症状得到改善，尤其是夜尿症（p=0.001）和压力性尿失禁（p=0.026）。在接受减重手术后的 6 个月内，绝经期是压力性尿失禁持续存在的最重要预测因素（p=0.046）。国际尿失禁咨询问卷尿失禁简表、患者总体印象改善量表和视觉模拟量表的自评结果和评分与显著改善相关（p=0.012、p=0.025 和 p=0.002）。
在接受减重手术之前，腰围较大的老年女性发生压力性尿失禁的风险更高。即使在减肥后，绝经期女性也极易出现持续性压力性尿失禁。减重手术所实现的体重减轻，改善了压力性尿失禁症状，并在绝大多数女性中减轻了其对生活质量的相关影响。
