Abstract: PD50-04
Sources of Funding: none

Introduction

Stress Urinary Incontinency (SUI) is a prevalent dysfunction encountered in obese patients. Although SUI is not a formal indication for bariatric surgery, patients who underwent this intervention report clinical improvement. The goal of this study is to characterize the epidemiological, antropometric and clinical profile of patients diagnosed with SUI before and after bariatric surgery.

Methods

Women in program of bariatric surgery of the Department of Surgery of Irmandade da Santa Casa de Misericórdia de São Paulo during the year of 2015-2016 were included, and only patients who did not complete the protocol questionnaire were excluded. The main variables evaluated: urinary stress test, weight, Body Mass Index (BMI), abdominal circumference (AC); number of pregnancies and parturition, POP-Q prolapse status, menopause status; smoking, diabetes, Visual Analog Scale (VAS) of satisfaction, International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF), Patient Global Impression of Improvement (IGP-I). Patients were submitted to this evaluation before and after 6 months of Roux-en-Y gastric bypass surgery. According to the result of the stress test, patients were divided in 3 groups: A- negative test before and after surgery, B- positive before and negative after surgery, C- positive test before and after surgery.

Results

Among the total of 46 patients enrolled in the study, 3 did not concluded the post-operation evaluation and were excluded. Patients were categorized in group A, group B and group C with 21, 16 and 6 patients respectively. In the preoperative period the factors to explain SUI were age and waist circumference. Each year of age increases the chances of SUI by 11,8%, each 10 centimeters more in abdominal circumference, increase the chances of SUI by 73,4%. Before the surgery, 22 (51,2%) were incontinent , 16 (72,7%) showed improvement and 6 (27,3%) remained incontinent (p=0,021). After the logistic regression analysis of groups B and C, there was a correlation with the variables ages over 52 years (p = 0.041), menopause (p = 0.029) were the most susceptible to IUE permanence. ICIQ-SF variation average in group B was 9,625 points and in group C was 6,5 points. Presence of uterine prolapse implicated in increasing up to 4,75 points in average on post-operation ICIQ-SF (p=0,03). VAS satisfaction average was higher in group B (8,84±1,12) than in group C(5,5±3,27). IGP-I showed better results in group B when compared to group C (p=0,065).

Conclusions

Weight loss through bariatric surgery completely improves SUI and its repercussions on quality of life in the vast majority of patients. Increased age and abdominal circumference raises the chance of SUI in obese women, and the age over 52 years and menopause are strongly related to the persistence of SUI after weight loss.

Funding

none