Prospective evaluation of urinary incontinence in severely obese adolescents presenting for weight loss surgery

Surg Obes Relat Dis. 2018 Feb;14(2):214-218. doi: 10.1016/j.soard.2017.09.510. Epub 2017 Sep 14.


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.

Keywords: Incontinence; Obesity; Weight loss surgery.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Bariatric Surgery / methods*
  • Body Mass Index*
  • Cohort Studies
  • Confidence Intervals
  • Female
  • Follow-Up Studies
  • Hospitals, Pediatric
  • Humans
  • Incidence
  • Male
  • Obesity, Morbid / complications*
  • Obesity, Morbid / diagnosis
  • Obesity, Morbid / surgery*
  • Odds Ratio
  • Postoperative Period
  • Preoperative Care / methods
  • Prospective Studies
  • Quality of Life*
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Time Factors
  • Treatment Outcome
  • United States
  • Urinary Incontinence / epidemiology
  • Urinary Incontinence / etiology*
  • Urinary Incontinence / physiopathology