Mihalsky K Paige, Tran Rachel, Moreno-Garcia Fernando, Stenberg Caitlin, Mier Giraud Fernando, Hare Adam, Quiroz Lieschen H, Fischer Laura E
Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, USA.
University of Oklahoma School of Medicine, Oklahoma City, OK, USA.
Surg Endosc. 2023 Nov;37(11):8791-8798. doi: 10.1007/s00464-023-10299-0. Epub 2023 Aug 16.
Obesity is a known risk factor for urinary incontinence (UI). As bariatric surgery can result in significant and sustainable weight loss, many chronic diseases closely linked to obesity have likewise shown improvement after surgical weight loss. We propose that bariatric surgery may significantly improve obesity-related UI symptoms as well as improve quality of life.
This is an interim analysis of an ongoing, prospective, single-institution observational study looking at UI in women enrolled in a bariatric surgery program. Participants completed the Pelvic Floor Distress Inventory (PFDI-20), International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF), King's Health Questionnaire (KHQ), and Patient Global Impression of Improvement (PGI-I). Questionnaires were administered upon enrollment, pre-operatively, and at 3, 6, and 12 months post-operatively. Demographic data were collected at each interval and analyzed with descriptive statistics.
At analysis, 108 patients had enrolled in the study and 60% had progressed to surgery. We analyzed the following surveys: enrollment (n = 108), pre-operative (n = 43), 3-month (n = 29), 6-month (n = 26), and 1-year (n = 27). Mean BMI decreased from 49.8 to 31.1 at 1-year. All surveys showed significant improvement in UI symptoms over time. Overall, UI symptoms (PDFI-20) are correlated with BMI at time of survey and %TBWL (p = 0.03, p = 0.019). Additionally, perception of symptom improvement with surgery (PGI-I) improved over time (3-month p = 0.0289, 6-month p = 0.0024, 12-month p = 0.0035). Quality of life related to UI symptoms (KHQ) significantly improved after surgery (p = 0.0047 3-month, p = 0.0042 6-month, p = 0.0165 1-year).
Although the relationship is complex and likely depends on many factors, weight loss after bariatric surgery is associated with improvement in UI symptoms and UI-related quality of life. Bariatric surgery can play a role in the long-term treatment of UI in women with obesity that may negate the need for further invasive UI procedures.
肥胖是已知的尿失禁（UI）风险因素。由于减肥手术可导致显著且可持续的体重减轻，许多与肥胖密切相关的慢性疾病在手术减肥后同样有所改善。我们提出，减肥手术可能会显著改善与肥胖相关的尿失禁症状，并提高生活质量。
这是一项正在进行的前瞻性单机构观察性研究的中期分析，该研究针对参与减肥手术项目的女性尿失禁情况进行观察。参与者完成了盆底困扰量表（PFDI - 20）、国际尿失禁咨询问卷 - 尿失禁简表（ICIQ - UI - SF）、国王健康问卷（KHQ）以及患者整体改善印象（PGI - I）。问卷在入组时、术前以及术后3个月、6个月和12个月进行发放。在每个时间间隔收集人口统计学数据，并进行描述性统计分析。
在分析时，108名患者已入组该研究，其中60%已进行手术。我们分析了以下调查数据：入组时（n = 108）、术前（n = 43）、3个月时（n = 29）、6个月时（n = 26）和1年时（n = 27）。1年时平均体重指数从49.8降至31.1。所有调查均显示，随着时间推移尿失禁症状有显著改善。总体而言，尿失禁症状（PDFI - 20）与调查时的体重指数以及总体重减轻百分比相关（p = 0.03，p = 0.019）。此外，对手术症状改善的感知（PGI - I）随时间有所改善（3个月时p = 0.0289，6个月时p = 0.0024，12个月时p = 0.0035）。与尿失禁症状相关的生活质量（KHQ）在手术后显著改善（3个月时p = 0.0047，6个月时p = 0.0042，1年时p = 0.0165）。
尽管这种关系复杂且可能取决于多种因素，但减肥手术后体重减轻与尿失禁症状及与尿失禁相关的生活质量改善相关。减肥手术可在肥胖女性尿失禁的长期治疗中发挥作用，这可能无需进一步进行侵入性尿失禁治疗程序。
