Effect of bariatric surgery on urinary and fecal incontinence: prospective analysis with 1-year follow-up.

BACKGROUND

Few studies have established that obesity promotes all types of urinary incontinence and disorders of the pelvic floor. The role of bariatric surgery in urinary incontinence remains poorly studied.

OBJECTIVE

To determine the effect of bariatric surgery on urinary incontinence, dysuria, and fecal incontinence before and 1 year after bariatric surgery.

SETTING

University hospital expert in bariatric surgery

METHODS

This was an observational cohort study of 140 patients who underwent bariatric surgery between September 2013 and September 2014. Patients prospectively completed 4 questionnaires, 2 for urinary symptoms and 2 for fecal incontinence. Eighty-three women and 33 men completed 4 questionnaires the day before surgery when arriving in the department and 1 year after surgery.

RESULTS

Of the 140 patients, 116 completely responded to the 4 questionnaires. The rate of urinary incontinence was 50.9% before surgery and 19% at 1-year follow-up (P<.0001). After bariatric surgery, there was improvement in the rate of stress urinary incontinence: 39.7% before surgery versus 15.5% at 1 year (P<.0001). In addition, there was an improvement in urinary urge incontinence: 36.8% versus 7.9% at 1 year (P<.0001). The dysuria rate was 19.8% before surgery versus 3.4% at 1 year (P<.0001). Bariatric surgery improved the quality of life related to urinary symptoms (P<.0001). One year after surgery, there was no significant difference in terms of prevalence and severity of fecal incontinence.

CONCLUSION

We confirmed with our study that weight loss after bariatric surgery improves stress urinary incontinence, urge incontinence, dysuria, and quality of life. However, we did not find any positive effect on fecal incontinence.