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      Therapeutics and Clinical Risk Management (submit here)

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      Effects of bariatric surgery on urinary incontinence


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          Obesity is an important modifiable etiological factor associated with several diseases. There is strong evidence that urinary incontinence (UI) is positively correlated with body mass index (BMI).


          One of the many benefits experienced by obese patients after bariatric surgery is decrease in UI. To investigate this correlation, we aimed to examine the effects of weight loss on UI in female patients who had undergone laparoscopic sleeve gastrectomy (LSG).

          Materials and methods

          Obese female patients (n=120), ≥18 years of age, and planning to undergo LSG were included in this prospective study. We administered the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) and Incontinence Impact Questionnaire (IIQ-7) to the patients prior to surgery and 6 months after the surgery. Using the collected data, we determined the incidence of UI and examined the relationship between the preoperative and postoperative BMI and UI values.


          The mean age of the patients was 39.19 (standard deviation [SD] =9.94) years and the mean preoperative BMI was 46.17 (SD =5.35). Of the 120 patients, 72 (60%) complained of UI preoperatively. Among these 72 patients, 23 (31.95%) described urge incontinence, 18 (25%) stress incontinence, and 31 (43.05%) mixed-type incontinence. At 6 months postoperatively, the percentage of excess weight loss was 70.33% (SD =14.84%). For all three UI subtypes, the 6-month postoperative ICIQ-UI-SF and IIQ-7 scores decreased significantly compared to the preoperative scores ( P<0.05).


          LSG results in a clinically significant improvement in most common types of UI, regardless of patient reproductive history, existence of comorbid conditions, and smoking status.

          Most cited references20

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          Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001.

          Obesity and diabetes are increasing in the United States. To estimate the prevalence of obesity and diabetes among US adults in 2001. Random-digit telephone survey of 195 005 adults aged 18 years or older residing in all states participating in the Behavioral Risk Factor Surveillance System in 2001. Body mass index, based on self-reported weight and height and self-reported diabetes. In 2001 the prevalence of obesity (BMI > or =30) was 20.9% vs 19.8% in 2000, an increase of 5.6%. The prevalence of diabetes increased to 7.9% vs 7.3% in 2000, an increase of 8.2%. The prevalence of BMI of 40 or higher in 2001 was 2.3%. Overweight and obesity were significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status. Compared with adults with normal weight, adults with a BMI of 40 or higher had an odds ratio (OR) of 7.37 (95% confidence interval [CI], 6.39-8.50) for diagnosed diabetes, 6.38 (95% CI, 5.67-7.17) for high blood pressure, 1.88 (95% CI,1.67-2.13) for high cholesterol levels, 2.72 (95% CI, 2.38-3.12) for asthma, 4.41 (95% CI, 3.91-4.97) for arthritis, and 4.19 (95% CI, 3.68-4.76) for fair or poor health. Increases in obesity and diabetes among US adults continue in both sexes, all ages, all races, all educational levels, and all smoking levels. Obesity is strongly associated with several major health risk factors.
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            NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel.

            Surgeons, gastroenterologists, endocrinologists, psychiatrists, nutritionists, and other health care professionals, as well as members of the public convened to address nonsurgical treatments for severe obesity, surgical treatments for severe obesity, and criteria for selection, the efficacy, and risks of surgical treatments for severe obesity, and the need for future research on and epidemiologic evaluation of these therapies. The National Institutes of Health Consensus Development Panel recommended that patients seeking therapy for severe obesity for the first time should be considered for treatment in a nonsurgical program that integrates a dietary regimen, appropriate exercise, behavior modification, and psychological support; that gastric restrictive or bypass procedures could be considered for well-informed and motivated patients in whom the operative risks were acceptable; that patients who are candidates for surgical procedures should be selected carefully after evaluation by a multidisciplinary team with medical, surgical, psychiatric, and nutritional expertise; that surgery be done by a surgeon who has substantial experience in the particular procedure and who works in a clinical setting with adequate support for all aspects of management and assessment; and that patients undergo lifelong medical surveillance after surgery.
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              Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group.

              This article describes short form versions of the Incontinence Impact Questionnaire (IIQ) and the Urogenital Distress Inventory (UDI). These instruments assess life impact and symptom distress, respectively, of urinary incontinence and related conditions for women. All subsets regression analysis was used to find item subsets that best approximated scores of the long form versions. The approach succeeded in reducing the 30-item IIQ and the 19-item UDI to 7- and 6-item short forms, respectively. The short form versions may be more useful than the long form versions in many clinical and research applications.

                Author and article information

                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                19 January 2017
                : 13
                : 95-100
                [1 ]General Surgery Department, Antalya Training and Research Hospital, Antalya
                [2 ]General Surgery Department, Esenler Maternity and Child Health Hospital, Istanbul
                [3 ]Urology Department, Antalya Training and Research Hospital, Antalya, Turkey
                Author notes
                Correspondence: Mani Habibi, General Surgery Department, Esenler Maternity and Child Health Hospital, Havaalanı Mahallesi, Taşocağı Caddesi, No 19, Esenler, Istanbul 34230, Turkey, Tel +90 555 678 8927, Email manihabibi@ 123456gmail.com
                © 2017 Bulbuller et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Original Research

                bariatric surgery,obesity,urinary incontinence
                bariatric surgery, obesity, urinary incontinence


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