W Robert DeFoor1, Thomas H Inge2, Todd M Jenkins3, Elizabeth Jackson3, Anita Courcoulas4, Marc Michalsky5, Mary Brandt6, Linda Kollar3, Changchun Xie7. 1. Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Electronic address: Bob.defoor@cchmc.org. 2. University of Colorado Denver, Aurora, Colorado. 3. Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 4. University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 5. Nationwide Children's Hospital, Columbus, Ohio. 6. Texas Children's Hospital, Houston, Texas. 7. University of Cincinnati, Cincinnati, Ohio.
Abstract
BACKGROUND: Obesity has been associated with daytime urinary incontinence (UI), likely due to increased intra-abdominal pressure. OBJECTIVES: To assess incontinence symptoms in severely obese adolescents before and 3 years after bariatric surgery. SETTING: Tertiary care pediatric hospitals in the United States. METHODS: The Teen-Longitudinal Assessment of Bariatric Surgery is a prospective, multicenter study designed to evaluate efficacy and safety of bariatric surgery in adolescents. Patients<19 years of age undergoing bariatric surgery at 5 centers between 2007 and 2012 were enrolled. Trained study staff collected baseline and postoperative anthropometric and clinical data. Presence and severity of UI were determined by standardized interview. RESULTS: A total of 242 patients (76% female) were evaluated at baseline. The mean age was 17.1 years at baseline, and 72% were of white race. The preoperative median body mass index was 50.5 kg/m2. At baseline, 18% of females and 7% of males reported UI. Prediction analysis at baseline indicated that females, white race, and increasing body mass index had greater odds for UI. UI prevalence in females and males decreased to 7% and 0%, respectively, at 6 months after surgery (P<.01) and remained stable out to 36 months postoperatively. Furthermore, older patients were less likely to achieve 3-year UI remission or improvement. CONCLUSIONS: In adolescents undergoing bariatric surgery, UI was more common in females than in males. Incontinence status significantly improved by 6 months and was durable to 3 years after surgery, suggesting that bariatric surgery favorably affects anatomic or physiologic mechanisms of bladder control in both males and females.
BACKGROUND:Obesity has been associated with daytime urinary incontinence (UI), likely due to increased intra-abdominal pressure. OBJECTIVES: To assess incontinence symptoms in severely obese adolescents before and 3 years after bariatric surgery. SETTING: Tertiary care pediatric hospitals in the United States. METHODS: The Teen-Longitudinal Assessment of Bariatric Surgery is a prospective, multicenter study designed to evaluate efficacy and safety of bariatric surgery in adolescents. Patients<19 years of age undergoing bariatric surgery at 5 centers between 2007 and 2012 were enrolled. Trained study staff collected baseline and postoperative anthropometric and clinical data. Presence and severity of UI were determined by standardized interview. RESULTS: A total of 242 patients (76% female) were evaluated at baseline. The mean age was 17.1 years at baseline, and 72% were of white race. The preoperative median body mass index was 50.5 kg/m2. At baseline, 18% of females and 7% of males reported UI. Prediction analysis at baseline indicated that females, white race, and increasing body mass index had greater odds for UI. UI prevalence in females and males decreased to 7% and 0%, respectively, at 6 months after surgery (P<.01) and remained stable out to 36 months postoperatively. Furthermore, older patients were less likely to achieve 3-year UI remission or improvement. CONCLUSIONS: In adolescents undergoing bariatric surgery, UI was more common in females than in males. Incontinence status significantly improved by 6 months and was durable to 3 years after surgery, suggesting that bariatric surgery favorably affects anatomic or physiologic mechanisms of bladder control in both males and females.
Authors: Michelle J Semins; John R Asplin; Kimberly Steele; Dean G Assimos; James E Lingeman; Susan Donahue; Thomas Magnuson; Michael Schweitzer; Brian R Matlaga Journal: Urology Date: 2010-04-08 Impact factor: 2.649
Authors: Wayne K Nelson; Scott G Houghton; Dawn S Milliner; John C Lieske; Michael G Sarr Journal: Surg Obes Relat Dis Date: 2005-08-26 Impact factor: 4.734
Authors: Allison A Hedley; Cynthia L Ogden; Clifford L Johnson; Margaret D Carroll; Lester R Curtin; Katherine M Flegal Journal: JAMA Date: 2004-06-16 Impact factor: 56.272