PD66-09 PERSISTENCE OF STRESS URINARY IN CONTINENCE IN OBESE AFTER BARIATRIC SURGERY, WHAT ARE THE RISK FACTORS?

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction III (PD66)1 Sep 2021PD66-09 PERSISTENCE OF STRESS URINARY IN CONTINENCE IN OBESE AFTER BARIATRIC SURGERY, WHAT ARE THE RISK FACTORS? Antonio Flavio Rodrigues, Fernando Korkes, Gabriel de Castro Bittar, Douglas de Padua Rodrigues, Felipe Araujo Santos, Wilson Rodrigues Junior, and Luis Gustavo Toledo Antonio Flavio RodriguesAntonio Flavio Rodrigues More articles by this author , Fernando KorkesFernando Korkes More articles by this author , Gabriel de Castro BittarGabriel de Castro Bittar More articles by this author , Douglas de Padua RodriguesDouglas de Padua Rodrigues More articles by this author , Felipe Araujo SantosFelipe Araujo Santos More articles by this author , Wilson Rodrigues JuniorWilson Rodrigues Junior More articles by this author , and Luis Gustavo ToledoLuis Gustavo Toledo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002110.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stress urinary incontinence (SUI) incontinence is frequently associated with severe obesity in women, and weight loss after bariatric surgery improve the symptoms. Our study aimed to examine variables associated with SUI in morbidly obese women before and after bariatric surgery, and to identify predictive factors to SUI persistence. METHODS: A prospective observational study was designed including 89 women from Santa Casa de São Paulo Bariatric Surgery Program between 2015 and 2018. Patients who did not accept to participate or did not complete the protocol were excluded from the study (n=6). Patients were evaluated, answered the ICIQ-SF (International Consultation on Incontinence Questionnaire – short form), PGI-I (Patient Global Impression of Improvement) and VAS (visual analogic scale), underwent physical examination and stress incontinence test before and 6 months after Y-en-Roux gastric bypass. Women were divided into three groups according to SUI: A-without SUI; B-preoperative SUI with postoperative resolution C-preoperative SUI without resolution. RESULTS: Of the 83 women who completed the study, the mean age was 43.3±7.6 years and BMI reduced from 45.5±5.7 kg/m2 to 34.1±6.9 kg/m2 (25% reduction). Preoperative incontinence rate was 53% (n=44). Observed 70.4% resolution the SUI after surgery (p=0.013). Predictive factors for SUI preoperative diagnosis after logistic regression included age above 44 years (p=0.022), BMI (p=0.038), largest newborn weight (Kg) (p=0.001) and parity number (p=0.003), and the increase of 1 in the value of each variable increases the possibility of SUI by 183%, 8%, 407% and 69%, respectively. All urinary symptoms demonstrated improvement after weight loss, markedly nocturia (p=0.03), SUI (p=0,03) and urinary incontinence (p=0.002). Logistic regression demonstrated that age above 50 years (p=0.004), hypertension (p=0,028), and menopause (p=0.004) were independent risk factors for SUI persistence. Obese women above 50 years burden a 9.5-fold, hypertension 11.2-fold and menopause 9.5-fold increased risk of persisting incontinent after weight reduction. Patient reported outcomes, ICIQ-SF, PGI-I and VAS for satisfaction demonstrated that SUI resolution was associated with significant improvement (p<0.001, p=0.01 and p=0.01 respectively). Predictive factors for SUI persistence after surgery was 9.5-fold higher if 2 factors were present and 13.8-fold for 3 factors (p<0,001). CONCLUSIONS: women above 44 years, high BMI, largest newborn weight and parity are risk factors for developing SUI in obese women. Older age, hypertension and menopause are strongly associated with persistence of SUI even after weight loss, and when these three factors are present, an increment of 13.8-fold occur. If these factors are not present, weight loss achieved through bariatric surgery resolves SUI symptoms and its impacts on quality of life on the majority of women. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1162-e1162 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Antonio Flavio Rodrigues More articles by this author Fernando Korkes More articles by this author Gabriel de Castro Bittar More articles by this author Douglas de Padua Rodrigues More articles by this author Felipe Araujo Santos More articles by this author Wilson Rodrigues Junior More articles by this author Luis Gustavo Toledo More articles by this author Expand All Advertisement Loading ...