Журнал терапии ожирения и снижения веса

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Lower Urinary Tract Symptoms and Sexual Dysfunction in the Bariatric Patient Population: A Comprehensive Review

Paulette C. Dreher, Gabrielle R. Yankelevich, Kelly Lurz, Shaun Hager, Antoine Ghorayeb, Daniel Edwards, Darlene Gaynor

Introduction & Objective: The growing epidemic of obesity is a leading cause of morbidity and is associated with dysfunction across multiple organ systems. Bariatric surgery may result in significant and sustained weight loss along with potential improvement of obesity-related comorbidities, including genitourinary dysfunctions. Recent data suggest the potential of bariatric surgery associated weight loss to improve urinary symptoms and sexual dysfunction (SD) in both men and women. The aim of this review is to assess the urinary and sexual function outcomes in the bariatric surgical patient.

Methods: PUBMED was searched in accordance with PRISMA guidelines for relevant articles in English. Ineligible articles were excluded and articles meeting all inclusion criteria (n=32) went on to review by 2 reviewers. Outcomes results were catalogued and summarized across articles. As a result of the substantial heterogeneity of outcome measures and follow-up intervals, meta-analytic techniques were not applied to the data.

Results: Most reports consist of one or more validated questionnaire (87.5%, n=28) and non-validated surveys (9.4%, n=3) prospectively given to patients preoperatively and postoperatively in order to demonstrate a significant improvement in urinary incontinence (UI) and/or sexual function after weight loss. We found that LUTS was evaluated in 53.1% (n=17), SD in 25% (n=8) and 21.9% evaluated both LUTS and SD. The most frequently utilized questionnaires were the ICIQ, PFDI and the IPSS. The majority of studies reported improvements in both LUTS 95.8% (n=23) and SD 66.7% (n=10).

Conclusion: Literature suggests a significant reduction in UI in patients who have undergone bariatric surgery. With regards to LUTS and SD, there appears to be improvement following bariatric surgery; however, the paucity and heterogeneity of literature examining SD and LUTS in the bariatric surgery population necessitates further research be performed.