Gastric Bypass May Reduce UI Rate in the Obese


NATIONAL HARBOR, MD. — Laparoscopic Roux-en-Y gastric bypass appears to rapidly resolve urinary incontinence in morbidly obese women, according to a recent prospective study.

The results of the study reinforce the importance of weight as a modifiable risk factor for urinary incontinence (UI), said Dr. Arthur M. Carlin, research director of the bariatric surgery program at Henry Ford Hospital, Detroit.

Of a total of 470 morbidly obese patients seeking bariatric surgery, UI occurred in 309 (66%), and in most of those, symptoms improved or resolved by 3 months after surgery with as little as 30 pounds of weight loss, Dr. Carlin reported at the annual meeting of the American Society for Metabolic and Bariatric Surgery.

When Dr. Carlin and his coinvestigators conducted their study in 2005-2007, they asked patients to fill out the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) at the initial preoperative visit and at 3 and 12 months after surgery. The ICIQ-SF is a validated, self-administered, one-page questionnaire that assesses UI symptoms and quality of life.

In 58 of the women who underwent laparoscopic Roux-en-Y gastric bypass and completed a follow-up questionnaire, the mean total symptom score on the ICIQ-SF improved significantly from 7.6 at baseline to 3 at 3 months and to 1.8 at 12 months. These 58 women had UI defined by stress (33%), urge (21%), or a mixture of both (46%). The greatest improvement occurred in women with stress UI caused by coughing, sneezing, or physical activity.

UI had resolved in 54% of these women at 3 months and in 64% at 12 months. When improvement was also included, these rates became 84% and 92%, respectively.

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