Sternau Magdalena, Czajkowski Mateusz, Wierzbicki Piotr, Kogut-Wierzbicka Marzena, Zarzyka Karolina, Milewczyk Maciej, Czurak Krzysztof, Proczko-Stepaniak Monika, Matuszewski Marcin
Department of Urology, Medical University of Gdańsk, 80-210 Gdańsk, Poland.
Department of Histology, Medical University of Gdańsk, 80-210 Gdańsk, Poland.
Medicina (Kaunas). 2025 Mar 22;61(4):564. doi: 10.3390/medicina61040564.
: To evaluate the long-term efficacy of bariatric surgery in ameliorating urinary incontinence in women with obesity. Additionally, to assess the impact of comorbidities on the persistence of symptoms and compare the effectiveness of two types of bariatric interventions. : This prospective, single-centre study included 124 women with preoperative urinary incontinence (UI). A total of 92 (74.19%) responded to follow-up and underwent laparoscopic sleeve gastrectomy (LSG) ( = 52; 56.52%) or one anastomosis gastric bypass (OAGB) ( = 40; 43.48%). The cohort was divided into stress urinary incontinence (SUI) ( = 57; 61.96%), mixed urinary incontinence (MUI) ( = 33; 35.87%), and urge urinary incontinence (UUI) ( = 2; 2.17%). Before surgery, patients were assessed for comorbidities and completed the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) (score range 0-21) and the Urogenital Distress Inventory (UDI-6) (score range 0-100) questionnaires. After 5 years, the patients completed the same questionnaires again for the final assessment. : Bariatric surgery demonstrated a statistically significant reduction in UI symptoms ( < 0.001), with a more pronounced improvement in SUI than in MUI, and with complete resolution in patients experiencing UUI. LSG was more effective than OAGB at alleviating UI ( < 0.001 vs. = 0.017). Notably, childbirth, particularly vaginal delivery, was associated with a higher risk of persistent UI after surgery ( = 0.025). The correlation between postoperative BMI and improvement in UI symptoms was not statistically significant ( = 0.64). : Bariatric surgery provides a beneficial secondary effect on urinary incontinence (UI) in women with obesity who undergo the procedure for obesity. The LSG method is superior to OAGB when considering the improvement in incontinence symptoms. Furthermore, the LSG procedure should be considered the primary choice for women with obesity experiencing UI with a history of vaginal delivery.
评估减肥手术改善肥胖女性尿失禁的长期疗效。此外，评估合并症对症状持续存在的影响，并比较两种减肥干预措施的有效性。：这项前瞻性单中心研究纳入了124例术前有尿失禁（UI）的女性。共有92例（74.19%）患者接受随访并接受了腹腔镜袖状胃切除术（LSG）（n = 52；56.52%）或单吻合口胃旁路术（OAGB）（n = 40；43.48%）。该队列分为压力性尿失禁（SUI）（n = 57；61.96%）、混合性尿失禁（MUI）（n = 33；35.87%）和急迫性尿失禁（UUI）（n = 2；2.17%）。手术前，对患者进行合并症评估，并完成国际尿失禁咨询问卷-尿失禁简表（ICIQ-UI SF）（评分范围0-21）和泌尿生殖系统困扰量表（UDI-6）（评分范围0-100）问卷。5年后，患者再次完成相同问卷进行最终评估。：减肥手术显示尿失禁症状有统计学意义的减轻（P < 0.001），SUI的改善比MUI更明显，UUI患者症状完全缓解。LSG在缓解尿失禁方面比OAGB更有效（P < 0.001 vs.P = 0.017）。值得注意的是，分娩，尤其是阴道分娩，与术后持续性尿失禁的风险较高相关（P = 0.025）。术后BMI与尿失禁症状改善之间的相关性无统计学意义（P = 0.64）。：减肥手术对因肥胖而接受该手术的肥胖女性尿失禁（UI）产生有益的次要影响。考虑到失禁症状的改善，LSG方法优于OAGB。此外，对于有阴道分娩史且患有尿失禁的肥胖女性，应考虑将LSG手术作为首选。
