Urinary incontinence is a common problem for women that are considered to be obese. These women seem to have increased incontinence the more obese that they are and the problem seems to be progressive as age goes on as well for these patients. New studies are showing that there is some significant improvement in the urinary incontinence in patients three years after they have had bariatric surgery. Leslee Subak, MD from the University of California in San Francisco gave information about this discovery at the American Urogynecologic Society and International Urogynecological Association Scientific Meeting of 2014.
During a sub-study with 1565 women 8% had been medicated for incontinence and 7% had been through surgery for incontinence. These individuals consisted of women with an average age of 46 years of which approximately 86% have been white. The average body mass index for these patients was 46 m/kg2 and considered to be severely obese. The patients were asked to fill out a questionnaire prior to surgery where 22% of them reported to experience a urinary continence episode on a weekly basis during the 3 months prior to the study. Another 27% were reported to have episodes of incontinence daily.
Most of the patients underwent Roux-en-Y gastric bypass surgery or laparoscopic adjustable band surgery. The weight loss was reported at an average of 30% of their excess body weight at years one and two and 29% at year three. At the one year mark the average number of urinary incontinence episodes dropped from 11 to 3 per week. This number increased to 4 episodes at year 2, but remained steady at year 3. These results were similar in both the urgency incontinence and stress incontinence.
For women at year 1 no incontinency was reported at all in 67% of the women, 60% of the women in year 2 and 50% at year 3. This was defined as being less than weekly incontinence episodes for these women. A complete remission with no episodes was reported by 29% of the women at year 1, 27% at year 2 and 27% at year 3. These results showed Dr. Subak that the improvement in incontinence was directly in correlation to the loss of weight. The more weight was lost the fewer incontinence episodes were reported.
The results of the study showed that for every 5% of body mass index that was lost by the patient, there was an approximate 30% larger chance that incontinence would improve. The women studied lost approximately 6 times more than this number and therefore had far better odds of improved incontinence up to 8-fold. Age also seemed to have some role in the results with less chance of improved incontinence in the older patients. The odds ratio for the patients in relation to age was 0.76 for each progressive decade accounted for. This is a small number, but does show a difference.
The findings of these studies lead to answers that seem to say even a small weight loss can improve the episodes of incontinence in women. The surgery and consequent weight loss seem to have a profound effect on these other weight related issues such as incontinence. This might mean that there are additional benefits to the weight loss. The benefits of weight loss through bariatric surgery is now more about the outside benefits and good health rather than simple things such as comfort and appearance. The surgery is helping other functions of day to day life see improvement for patients.
Regardless of the type of incontinence that the patient suffers from, there are obvious positive results from bariatric surgery and weight loss. The improvement at 3 years and consistent holding of remission and improvement is clear indication that there is something to be said for weight loss surgery and the results for incontinence. These factors bring new light to the long and growing list of benefits associated with bariatric surgery.