Does bariatric surgery affect urinary incontinence?

Objective: To determine International Classification of Disease, 9th Revision, (ICD-9) coding patterns as a proxy for incidence and prevalence of urinary incontinence (UI) in a population of patients before and after a bariatric surgical procedure for the treatment of obesity. Methods: We evaluated claims from a national private insurer over a 5-year period (2002-2006) to identify female patients who underwent bariatric surgery and had 3 years of follow-up claims data. The cohort of patients who underwent bariatric surgery (treatment) was matched to a cohort of obese female patients who did not undergo bariatric surgery (control), who were followed from the start of their enrollment. UI was identified by ICD-9 coding. Results: After bariatric surgery, 62.4% of patients (83/133) diagnosed with UI before their surgery no longer had a coding diagnosis of UI. In contrast, only 42.1% (56/133) of those in the nonbariatric surgery cohort lost their coding diagnosis of UI (P =.0009). Of those that did not have pre-existing UI, 6.2% (235/3765) of the bariatric surgery cohort gained a new coding diagnosis of UI vs 7.1% (269/3765) of the control group (P =.1169). Our final model suggested that age >45 years (P <.0001) and pre-existing UI (P <.0001) were significantly associated with post-index date UI. Interaction between bariatric surgical status and UI was also significant (P <.0001). Conclusion: Patients who undergo bariatric surgery are more likely to lose a previous diagnosis of UI than are obese patients not treated with bariatric surgery. This supports the fact that bariatric surgery may have other indirect benefits to the obese population.