Improvement of voiding characteristics in morbidly obese women after bariatric surgery: A single-center study with a 1-year follow-up.

BACKGROUND: It is well known that morbid obesity in women is related to lower urinary tract symptoms, including urinary incontinence. Although several studies have reported on the improvement in urinary incontinence after bariatric surgery, few reports have focused on the detailed changes in other voiding characteristics.

OBJECTIVE: To demonstrate the real benefit of bariatric surgery on lower urinary tract symptoms.

SETTING: Bariatric Center of Excellence and Health Promotion at Soonchunhyang University Hospital.

METHODS: From August to December 2012, a total of 57 women out of 183 women who underwent bariatric surgery agreed to be assessed for voiding dysfunction during their preoperative and 1-year postoperative evaluation using the international prostate symptom score, quality of life score, an overactive bladder symptom score, a patient perception of bladder score, and a Sandvick questionnaire for urinary incontinence. For statistical analysis, the Wilcoxon sign rank and Fisher׳s exact tests were used to assess a significant change in voiding status.

RESULTS: Among a total of 183 women in the bariatric center, 57 women completed the full version of the urologic questionnaire. The baseline mean age of those patients was 38.5±9.5 and their baseline mean body mass index (BMI) was 37.5±5.9 (68.4% were over BMI 35). One year after bariatric surgery (Roux-en-Y gastric bypass), BMI showed a significant change, 9.5±3.5 (63.1% were below BMI 28). For specific characteristic changes in voiding status, the international prostate symptom score, quality of life score, overactive bladder symptom score, and patient perception of bladder score revealed significant improvement over baseline: 3.2±4.0, .6±.9, 1.6±2.3, and .5±1.0, respectively. For stress-related urinary incontinence as assessed using the Sandvick questionnaire, preoperative evaluation demonstrated the prevalence to be 40.74%, and 18.51% postoperatively.

CONCLUSION: At a 1-year postoperative follow-up after laparoscopic gastric bypass-type bariatric surgery, there were significant improvements in voiding status as assessed by several standard urologic voiding questionnaires/indices.