To evaluate the effectiveness of surgical weight loss interventions, in overweight and obese women with UI with up to one-year follow-up.

Study Design: 
A systematic review and meta-analysis which were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) guidance.

Included Studies: 
Retrospective and prospective cohort studies examining bariatric surgery's impact on UI were included.

Included Participants: 
Eligible studies involved women (≥18 years) with a mean BMI ≥25 kg/m² who had UI and underwent surgical weight loss. All UI types (SUI, UUI, MUI) were considered. 

Exclusion Criteria: 
Studies were excluded if they did not assess UI pre- and post-intervention, had <6 months follow-up, lacked sufficient data.

Interventions: 
Included bariatric procedures were Laparoscopic Gastric Banding (LGB), Laparoscopic Sleeve Gastrectomy (LSG), Roux-en-Y Gastric Bypass (RYGB), Sleeve Gastrectomy (SG), Anastomosis Gastric Pouch (Anastomosis GP), and Duodenal Switch (DS).

Search Strategy: 
A comprehensive search was conducted in MEDLINE, EMBASE, PRIMO, PubMed, and Google Scholar, using MeSH terms and free-text phrases. Manual searches were performed. No language restrictions. Literature search and screening were conducted by two independent reviewers, with any discrepancies discussed with senior reviewer.

Study Selection & Data Extraction: 
Studies were screened in phases. Data were extracted into an Excel-spreadsheet. These were conducted by two independent reviewers, with any discrepancies discussed with senior reviewer.

Primary Outcome:
•	Subjective cure rate of UI determined through individual self-reports and validated questionnaires.
•	Objective cure rate of UI determined by pad usage, voiding diaries, or urodynamic studies.
Secondary Outcome:
•	Assess the impact of surgical intervention on quality of life, sexual function, pelvic organ prolapse, and body mass index (BMI).

Assessment of Risk of Bias & Study Quality: 
Study quality was evaluated using the Newcastle-Ottawa Scale (NOS), with scores of 7-9 considered high quality, 4-6 fair, and ≤3 poor.

Data Synthesis: 
Analysis was conducted using RevMan software Web version 5.6.0.

42 studies were included, from the period of 1990- March 2025. Figure 1a&b shows the incidence of UI in obese women significantly reduced at 6 months (odds ratio (OR)= 3.56, 95% CI [2.27, 5.59], P< 0.00001) and 12 months after bariatric surgery (OR= 3.90, 95% CI [2.30, 6.61], P< 0.00001). Findings suggest that bariatric surgery leads to significant improvements in the incidence of UI among obese women, with some patients achieving complete resolution of symptoms. 

Additionally, Figure 2 shows that weight loss following bariatric procedures was associated with improved BMI at 6 months (standardised mean difference (SMD)= 1.91, 95% CI [1.28, 2.54], P< 0.00001) and at 12 months (SMD= 2.16, 95% CI [1.83, 2.49], P< 0.00001). The findings demonstrated a statistically significant reduction in both UI incidence and BMI at 6- and 12-months post-surgery, with a pooled effect size indicating a strong correlation between weight loss, UI prevalence and BMI improvement.  

We will report further secondary outcome analysis and update our literature search and meta-analysis at the conference.

The data indicate that weight reduction through bariatric surgery is an effective intervention for managing UI in obese women, this proves to be statistically significant, at both 6 and 12 months postoperatively.

This meta-analysis demonstrated that surgical weight loss interventions effectively improve UI in overweight and obese women. However, results should be interpreted with caution due to variability among included studies. While surgical weight loss appears promising, further high-quality research is needed to confirm its full impact.