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Valipour R, Narouie B, Dadpour M, Torabinavid P, Momeni H, Radpour N, Ahmadzade M, Rouientan H, Danesh H, Emami MA. Impacts of Bariatric Surgery on Improvement of Incontinence Among Obese Asian Women: A Prospective Study and Literature Review. Obes Surg 2024; 34:1425-1431. [PMID: 38517646 DOI: 10.1007/s11695-024-07172-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION Limited studies investigate bariatric surgery's role in improving UI status among Asians, specifically Middle Eastern Asian women. The aim of this study is to investigate the effect of bariatric surgery on the three most prevalent urine incontinence (UI).We also reviewed the current literature exploring the studies performed in Asian countries. MATERIALS AND METHODS A total of 77 women out of 200 who had UI and indications for bariatric surgery completed demographic information and the questionnaire (QUID) prior to surgery and 6 months after the surgery. For statistical analysis, the Mann-Whitney U test, Wilcoxon test, and Friedman test were utilized. We also performed a literature review with the aim of investigating studies performed in Asian countries. RESULTS Among the initial analysis of 200 participants, 50.5% reported UI symptoms before surgery. The average weight loss was 29 kg, with a standard deviation of 7 kg. The mean BMI dropped 11.2 kg/m2, and the standard deviation was 2.5 after weight loss. Post-surgery, significant reductions in UI scores were observed across all severity levels, with a notable 44% achieving complete symptom resolution, indicating a substantial decrease in urinary incontinence. Stress, urine incontinence, and mixed urine incontinence symptoms had improved in 75%, 71%, and 30% of women, respectively. Notably, age and gynecological history were identified as critical factors influencing the extent of UI improvement. CONCLUSION This study reveals significant improvements in urinary incontinence scores, with age and gynecological history playing pivotal roles in UI improvement.
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Affiliation(s)
- Reza Valipour
- Department of Urology, Tehran Medical Sciences Branch, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Behzad Narouie
- Department of Urology, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Mehdi Dadpour
- Department of Urology, Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parham Torabinavid
- Department of Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Science, Tehran, Iran
| | - Hamidreza Momeni
- Department of Urology, Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negar Radpour
- Department of Urology, Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohadese Ahmadzade
- Department of Urology, Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Rouientan
- Department of Urology, Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hoseinali Danesh
- Department of Surgery, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohammad Aref Emami
- Department of Surgery, Zahedan University of Medical Sciences, Zahedan, Iran
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Güneş Y, Fersahoğlu MM, Bulut NE, Çakmak A, Ergin A, Teke E, Karataş TC, Şahin A, Sancak S. Effects of Sleeve Gastrectomy on Pelvic Floor Disorders in Female Patients with Severe Obesity: a Prospective Study. Obes Surg 2023; 33:3069-3076. [PMID: 37428362 DOI: 10.1007/s11695-023-06725-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Obesity is associated with pelvic floor disorders (PFD). Sleeve gastrectomy (SG) is one of the most effective weight loss methods. Although SG has been found to improve urinary incontinence (UI) and overactive bladder (OAB), its impact on fecal incontinence (FI) remains controversial. MATERIALS AND METHODS This prospective, randomized study involved 60 female patients with severe obesity who were randomly assigned to two groups: the SG group and the diet group. The SG group underwent SG, while the diet group received a low-calorie, low-lipid diet for 6 months. The patients' condition was assessed before and after the study using three questionnaires: the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), the Overactive Bladder 8-Question Awareness Tool (OAB-V8), and the Wexner Score (CCIS). RESULTS After 6 months, the SG group had a significantly higher percentage of total weight loss (%TWL) compared to the diet group (p<0.01). Both groups showed a decrease in the ICIQ-FLUTS, OAB-V8, and CCIS scores (p<0.05). UI, OAB, and FI improved significantly in the SG group (p<0.05), but no improvement was observed in the diet group (p>0.05). The correlation between %TWL and PFD was statistically significant but weak, with the strongest correlation between %TWL and ICIQ-FLUTS score and the weakest correlation between %TWL and CCIS score (p<0.05). CONCLUSIONS We recommend bariatric surgery for the treatment of PFD. However, given the weak correlation between %TWL and PFD after SG, further research should explore factors other than %TWL that are effective in recovery, particularly in relation to FI.
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Affiliation(s)
- Yasin Güneş
- Department of General Surgery, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey.
| | - Mehmet Mahir Fersahoğlu
- Department of General Surgery, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
| | - Nuriye Esen Bulut
- Department of General Surgery, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
| | - Ahmet Çakmak
- Department of General Surgery, Sinop Atatürk State Hospital, 57000, Sinop, Turkey
| | - Anıl Ergin
- Department of General Surgery, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
| | - Emre Teke
- Department of General Surgery, Haydarpaşa Numune Training And Research Hospital, Tıbbiye Cad. No: 23 Üsküdar, 34668, Istanbul, Turkey
| | - Tuğba Caner Karataş
- Department of General Surgery, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
| | - Aytaç Şahin
- Department of Urology, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
| | - Seda Sancak
- Department of Internal Medicine/Endocrinology and Metabolism Disorders, Fatih Sultan Mehmet Training And Research Hospital, İçerenköy Mahallesi, Hastane Sokak, No:1/8 Ataşehir, 34752, Istanbul, Turkey
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The Impact of Bariatric Surgery on Nocturia Symptoms: a Systematic Review and Meta-Analysis. Obes Surg 2022; 32:3150-3155. [PMID: 35864289 DOI: 10.1007/s11695-022-06215-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 10/17/2022]
Abstract
There is a significant association between obesity and nocturia, which can cause a significant negative impact on quality of life. This meta-analysis aims to determine the effects of bariatric surgery on nocturia in both men and women. Studies searched via MEDLINE and Embase databases. The primary outcome was difference in nocturia scores before and after bariatric surgery. A total of 522 patients were included in the analysis of this paper. Statistically significant decreases in nocturia scores were observed post-bariatric surgery. Bariatric surgery also resulted in statistically significant reduction of BMI. Bariatric surgery can have significant improvements on nocturia symptoms in men and women with obesity. This would thereby reduce morbidity and improve quality of life following bariatric surgery.
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Metabolism of fatty acids and bile acids in plasma is associated with overactive bladder in males: potential biomarkers and targets for novel treatments in a metabolomics analysis. Int Urol Nephrol 2020; 52:233-238. [DOI: 10.1007/s11255-019-02299-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 09/23/2019] [Indexed: 10/25/2022]
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American Urogynecologic Society Systematic Review: The Impact of Weight Loss Intervention on Lower Urinary Tract Symptoms and Urinary Incontinence in Overweight and Obese Women. Female Pelvic Med Reconstr Surg 2020; 26:16-29. [DOI: 10.1097/spv.0000000000000802] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Omae K, Yamamoto Y, Kurita N, Takeshima T, Naganuma T, Takahashi S, Ohnishi T, Ito F, Yoshioka T, Fukuhara S. Gait speed and overactive bladder in the healthy community‐dwelling super elderly: The Sukagawa Study. Neurourol Urodyn 2019; 38:2324-2332. [DOI: 10.1002/nau.24148] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/04/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Kenji Omae
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT)Fukushima Medical University Hospital Fukushima City Fukushima Japan
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE)Fukushima Medical University Fukushima City Fukushima Japan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of MedicineKyoto University Kyoto Japan
- Department of UrologyTokyo Women's Medical University Tokyo Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of MedicineKyoto University Kyoto Japan
| | - Noriaki Kurita
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT)Fukushima Medical University Hospital Fukushima City Fukushima Japan
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE)Fukushima Medical University Fukushima City Fukushima Japan
- Department of Clinical Epidemiology, Graduate School of MedicineFukushima Medical University Fukushima Japan
| | - Taro Takeshima
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE)Fukushima Medical University Fukushima City Fukushima Japan
| | - Toru Naganuma
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE)Fukushima Medical University Fukushima City Fukushima Japan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of MedicineKyoto University Kyoto Japan
| | - Sei Takahashi
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE)Fukushima Medical University Fukushima City Fukushima Japan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of MedicineKyoto University Kyoto Japan
| | - Tsuyoshi Ohnishi
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE)Fukushima Medical University Fukushima City Fukushima Japan
| | - Fumihito Ito
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE)Fukushima Medical University Fukushima City Fukushima Japan
- Department of Clinical Epidemiology, Graduate School of MedicineFukushima Medical University Fukushima Japan
- Department of Emergency MedicineInternational University of Health and Welfare Narita City Chiba Japan
| | - Takashi Yoshioka
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE)Fukushima Medical University Fukushima City Fukushima Japan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of MedicineKyoto University Kyoto Japan
| | - Shunichi Fukuhara
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE)Fukushima Medical University Fukushima City Fukushima Japan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of MedicineKyoto University Kyoto Japan
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Lee Y, Yu J, Tikkinen KA, Pędziwiatr M, Major P, Aditya I, Krakowsky Y, Doumouras AG, Gmora S, Anvari M, Hong D. The impact of bariatric surgery on urinary incontinence: a systematic review and meta-analysis. BJU Int 2019; 124:917-934. [DOI: 10.1111/bju.14829] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Yung Lee
- Michael G. DeGroote School of Medicine; McMaster University; Hamilton ON Canada
- Division of General Surgery; Department of Surgery; McMaster University; Hamilton ON Canada
- Centre for Minimal Access Surgery (CMAS); St. Joseph's Healthcare; McMaster University; Hamilton ON Canada
| | - James Yu
- Division of General Surgery; Department of Surgery; McMaster University; Hamilton ON Canada
- Centre for Minimal Access Surgery (CMAS); St. Joseph's Healthcare; McMaster University; Hamilton ON Canada
| | - Kari A.O. Tikkinen
- Departments of Urology and Public Health; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Michał Pędziwiatr
- 2nd Department of General Surgery; Jagiellonian University; Krakow Poland
- Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery); Krakow Poland
| | - Piotr Major
- 2nd Department of General Surgery; Jagiellonian University; Krakow Poland
- Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery); Krakow Poland
| | - Ishan Aditya
- Faculty of Medicine; University of Toronto; Toronto ON Canada
| | - Yonah Krakowsky
- Division of Urology; Department of Surgery; Women's College Hospital and Sinai Health System; University of Toronto; Toronto ON Canada
| | - Aristithes G. Doumouras
- Division of General Surgery; Department of Surgery; McMaster University; Hamilton ON Canada
- Centre for Minimal Access Surgery (CMAS); St. Joseph's Healthcare; McMaster University; Hamilton ON Canada
| | - Scott Gmora
- Division of General Surgery; Department of Surgery; McMaster University; Hamilton ON Canada
- Centre for Minimal Access Surgery (CMAS); St. Joseph's Healthcare; McMaster University; Hamilton ON Canada
| | - Mehran Anvari
- Division of General Surgery; Department of Surgery; McMaster University; Hamilton ON Canada
- Centre for Minimal Access Surgery (CMAS); St. Joseph's Healthcare; McMaster University; Hamilton ON Canada
| | - Dennis Hong
- Division of General Surgery; Department of Surgery; McMaster University; Hamilton ON Canada
- Centre for Minimal Access Surgery (CMAS); St. Joseph's Healthcare; McMaster University; Hamilton ON Canada
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Purwar B, Cartwright R, Cavalcanti G, Digesu GA, Fernando R, Khullar V. The impact of bariatric surgery on urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J 2019; 30:1225-1237. [PMID: 31028418 DOI: 10.1007/s00192-018-03865-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/28/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Obesity and overweight are strongly associated with stress and urgency urinary incontinence, and weight loss has been associated with improvement in urinary incontinence. We aimed to measure pooled effect sizes for different weight loss procedures on incontinence-specific quality of life and incontinence cure rate in a systematic review and meta-analysis. METHODS MEDLINE, Embase and the Cochrane library were searched using a pre-defined strategy for relevant cohort studies. Random effects meta-analyses were conducted for the weighted mean difference for urinary quality of life scores and weighted overall pooled estimates for proportions of women cured. We explored heterogeneity using meta-regression, testing the type of bariatric surgery and change in BMI as predictors of effect size. The studies were categorised as either low or high risk of bias using a novel instrument specifically designed for longitudinal symptom research studies. RESULTS Twenty-three studies (n = 3,225) were included. Incontinence-specific quality of life scores were improved by 14% (weighted mean difference = -14.79; CI = -18.47 to -11.11; I2 = 87.1%); the proportion of women cured of any urinary incontinence was 59% (95% CI = 51 to 66%) and the proportion of women cured of stress urinary incontinence was 55% (95% CI = 40 to 70%). CONCLUSIONS Bariatric surgery results in clinically meaningful improvements in incontinence-specific quality of life. Current data are limited by both short-term follow-up and unexplained heterogeneity among studies.
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Affiliation(s)
- Bhawana Purwar
- Department of Urogynaecology, Singleton Hospital, Sketty Lane, Swansea, Wales, SA2 8QA, UK.
| | - Rufus Cartwright
- Department of Urogynaecology, John Radcliffe Hospital, Oxford, UK
| | - Geraldo Cavalcanti
- Federal University of Pernambuco (UFPE), Recife, Brazil and University of Pernambuco (UPE), campus Recife, Recife, Brazil
| | | | - Ruwan Fernando
- Department of Urogynaecology, St Mary's Hospital, London, UK
| | - Vik Khullar
- Department of Urogynaecology, St Mary's Hospital, London, UK
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Cayci HM, Oner S, Erdogdu UE, Nas İ, Dilektasli E, Demirbas M. The Factors Affecting Lower Urinary Tract Functions in Patients Undergoing Laparoscopic Sleeve Gastrectomy. Obes Surg 2018; 28:1025-1030. [PMID: 29058241 DOI: 10.1007/s11695-017-2961-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND We prospectively assessed changes in the lower urinary system functions of women with morbid obesity following laparoscopic sleeve gastrectomy and the factors affecting these changes. METHODS Data from 40 females who had undergone laparoscopic sleeve gastrectomy due to morbid obesity (body mass index, BMI ≥ 40 kg/m2) between January 2014-2016 at S.B.U. Bursa Yuksek Ihtisas Training and Research Hospital were prospectively evaluated. The presence of comorbidities, onset of obesity, smoking, American Society of Anesthesiologists (ASA) score, pre and 12-month postoperative weights and BMIs, fasting blood glucose (FBG), blood urea nitrogen, creatinine, insulin, homeostatic model assessment-insulin resistance (HOMA-IR) test results, overactive bladder survey (OAB-Q) scores, volume of urination, and Qmax values obtained from uroflowmetry studies were recorded and assessed. RESULTS Statistically significant differences in weight, BMI, FBG, insulin, HOMA-IR score and creatinine values pre-operation, and the corresponding values obtained at 12 months post-operation were observed (all, p < 0.001). OAB-Q scores were observed to be statistically significantly lower in the postoperative period relative to those in the preoperative period (p < 0.001). Urination volume was statistically significantly higher during the postoperative period (p = 0.048) than during the preoperative period. Non-smoking patients showed a reduction in OAB-Q score and a statistically significant increase in urination volume during the postoperative period (p < 0.001, p = 0.011, respectively); smoking patients indicated a statistically significant reduction in OAB-Q score only during the postoperative period; however, urination volume was not statistically significant between two groups (p = 0.013, p = 0.303). In patients with an ASA score of 1, preoperative OAB-Q scores were statistically significantly lower (p = 0.035) than those obtained post-operation. Patients with childhood-onset obesity showed statistically significantly increased urination volumes during postoperative period in comparison with values obtained pre-operation (p = 0.042). CONCLUSION Improvements in lower urinary system functions were affected by patient-related factors, such as comorbidity, obesity onset, smoking, ASA score, and weight loss, following laparoscopic sleeve gastrectomy.
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Affiliation(s)
- Haci Murat Cayci
- Department of General Surgery, Bursa Yuksek Ihtisas Teaching and Research Hosiptal, 16310, Bursa, Turkey.
| | - Sedat Oner
- Department of Urology, Bursa Yuksek Ihtisas Teaching and Research Hospital, Bursa, Turkey
| | - Umut Eren Erdogdu
- Department of General Surgery, Bursa Yuksek Ihtisas Teaching and Research Hosiptal, 16310, Bursa, Turkey
| | - İdris Nas
- Department of Urology, Bursa Yuksek Ihtisas Teaching and Research Hospital, Bursa, Turkey
| | - Evren Dilektasli
- Department of General Surgery, Bursa Yuksek Ihtisas Teaching and Research Hosiptal, 16310, Bursa, Turkey
| | - Murat Demirbas
- Department of Urology, Bursa Yuksek Ihtisas Teaching and Research Hospital, Bursa, Turkey
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Caputo C, Uhr A, Murphy A. Weight Loss and Overactive Bladder. CURRENT BLADDER DYSFUNCTION REPORTS 2018. [DOI: 10.1007/s11884-018-0487-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Is there an association between aspects of the metabolic syndrome and overactive bladder? A prospective cohort study in women with lower urinary tract symptoms. Eur J Obstet Gynecol Reprod Biol 2017; 217:1-5. [DOI: 10.1016/j.ejogrb.2017.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 11/16/2022]
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Abstract
BACKGROUND Little is known regarding the effect of bariatric surgery on urinary incontinence. METHODS Between September 2008 and November 2014, 240 female patients underwent bariatric surgery. RESULTS The prevalence of urinary incontinence preoperatively was 45 % (108). Eighty-two (76 %) completed urinary function questionnaires pre-operatively and post-operatively. Fifty-seven (70 %) underwent laparoscopic gastric bypass, twenty-four (29 %) underwent sleeve gastrectomy and one underwent a banding procedure. Thirty-one (38 %) reported leaking on sneezing or coughing-stress urinary incontinence (SUI). Thirteen (16 %) complained of leaking before reaching the toilet-overactive bladder syndrome (OAB). The remaining thirty-eight (46 %) reported mixed symptoms. The mean pre-operative weight and BMI were 133 (18) kg and 50 (SD = 6.2) kg/m(2) respectively. The mean post-operative BMI drop was 16 (SD = 5.2) kg/m(2). Preoperatively, 61 (75 %) reported moderate to very severe urinary incontinence compared to 30 (37 %) post-operatively (χ (2) = 3.24.67, p = 0.050). Twenty-seven (33 %) patients reported complete resolution of their urinary incontinence. Fifty-one (62 %) patients required incontinence pads on a daily basis pre-operatively, compared to 35 (43 %) post-operatively (χ (2) = 22.211.6, p = 0.00). The mean International Consultation on Incontinence Questionnaire- Urinary Incontinence short form (ICIQ-UI SF) score was 9.3 (SD = 4.4) pre-operatively compared to 4.9 (SD = 5.3) post-operatively (t = 7.2, p = 0.000). The improvement score post-operatively was 8 (SD = 3). A significant difference in the ICIQ-UI SF was identified between OAB and SUI groups when adjusting for age, number of children, type of delivery and pre-op BMI (t = 1.98, p = 0.05). CONCLUSION Bariatric surgery results in a clinically significant improvement in urinary incontinence. However, this is not proportional to pre-operative BMI, weight loss, age, parity and mode of delivery.
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Bland CM, Quidley AM, Love BL, Yeager C, McMichael B, Bookstaver PB. Long-term pharmacotherapy considerations in the bariatric surgery patient. Am J Health Syst Pharm 2016; 73:1230-42. [PMID: 27354038 DOI: 10.2146/ajhp151062] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Pharmacists' role in optimizing long-term pharmacotherapy for bariatric surgery patients is detailed. SUMMARY Bariatric surgery patients provide a difficult challenge in terms of many pharmacotherapy issues, especially in the chronic care setting, where data on long-term effects of bariatric surgery are limited. The most common procedures are Roux-en-Y gastric bypass (RYGB), adjustable gastric banding, and sleeve gastrectomy. Sleeve gastrectomy has become the most common procedure in the United States, primarily because it has less overall chronic malabsorption effects than RYGB. Pharmacotherapy management is complicated by rapid weight loss combined with a number of pharmacokinetic changes, such as decreased absorption of some medications due to altered gastrointestinal tract anatomy and potentially increased concentrations of some medications due to a decreased volume of distribution resulting from weight loss. Nutritional and metabolic supplementation are of the utmost importance in order to limit deficiencies that can lead to a number of conditions. Many chronic diseases, including hypertension, diabetes, gastroesophageal reflux disease, and urinary incontinence, are improved by bariatric surgery but require close monitoring to ensure the effectiveness of maintenance pharmacotherapy and avoidance of adverse effects. Psychotropic medication management is also an important pharmacotherapy concern, as evidenced by antidepressants being the most commonly used medication class among preoperative bariatric surgery patients. CONCLUSION Pharmacists have an increasing role in the chronic management of the bariatric surgery patient due to their knowledge of medication dosage forms and expertise in disease states affected by bariatric surgery.
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Affiliation(s)
- Christopher M Bland
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Southeastern Campus, Savannah, GA.
| | | | - Bryan L Love
- Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC
| | - Catherine Yeager
- Family Medicine and Outpatient Behavioral Health Services, Eisenhower Army Medical Center, Fort Gordon, GA
| | | | - P Brandon Bookstaver
- Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC
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Pomian A, Lisik W, Kosieradzki M, Barcz E. Obesity and Pelvic Floor Disorders: A Review of the Literature. Med Sci Monit 2016; 22:1880-6. [PMID: 27255341 PMCID: PMC4907402 DOI: 10.12659/msm.896331] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Overweight and obesity are becoming a worldwide health problem associated with numerous co-morbidities. National costs of obesity and pelvic flor disorders have been rising since the 1950s across the world. Obesity is thought to have a very strong effect on pelvic floor disorders, and, considering the high prevalence of both problems worldwide, it is of utmost importance to evaluate the association between these pathologies as well as the impact of obesity on treatment efficacy. This review is based on a selection of reports in the literature (PubMed search), including guidelines and Cochrane reviews. Obesity seems to be a well-documented risk factor for lower urinary tract symptoms (LUTS) and is a predictor of exacerbation of stress urinary incontinence (SUI) and overactive bladder (OAB). Weight loss is also associated with improvement or resolution of SUI and OAB. In the case of pelvic organ prolapse (POP), weight loss is associated with improvement in quality of life. Although obesity is associated with POP in general, the exact role of obesity in symptomatic POP remains uncertain. While outcomes of anti-incontinence surgery among obese women are similar to those in non-obese women, postoperative urge incontinence is more likely to occur. It seems that obesity is not a risk factor for postoperative complications or short-term efficacy of POP surgical treatment. Long-term effects are still uncertain. Obesity is a strong risk factor for LUTS, but in most cases it does not affect efficacy of operative treatment. It may be associated with some post-operative complications. Weight loss in many cases allows avoiding surgical intervention.
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Affiliation(s)
- Andrzej Pomian
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Lisik
- Deparment of General Surgery and Transplantology, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Kosieradzki
- Deparment of General Surgery and Transplantology, Medical University of Warsaw, Warsaw, China (mainland)
| | - Ewa Barcz
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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Groutz A, Gordon D, Schachter P, Amir H, Shimonov M. Effects of bariatric surgery on male lower urinary tract symptoms and sexual function. Neurourol Urodyn 2016; 36:636-639. [DOI: 10.1002/nau.22980] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 01/31/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Asnat Groutz
- Sackler Faculty of Medicine, Urogynecology and Pelvic Floor Unit, Tel Aviv Sourasky Medical Center, Lis Maternity Hospital; Tel Aviv University; Tel Aviv Israel
| | - David Gordon
- Sackler Faculty of Medicine, Urogynecology and Pelvic Floor Unit, Tel Aviv Sourasky Medical Center, Lis Maternity Hospital; Tel Aviv University; Tel Aviv Israel
| | - Pinhas Schachter
- Sackler Faculty of Medicine, Department of Surgery, E. Wolfson Medical Center; Tel Aviv University; Tel Aviv Israel
| | - Hadar Amir
- Sackler Faculty of Medicine, Urogynecology and Pelvic Floor Unit, Tel Aviv Sourasky Medical Center, Lis Maternity Hospital; Tel Aviv University; Tel Aviv Israel
| | - Mordechai Shimonov
- Sackler Faculty of Medicine, Department of Surgery, E. Wolfson Medical Center; Tel Aviv University; Tel Aviv Israel
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