Patients with overweight and obesity have a higher prevalence of lower urinary tract symptoms (LUTS) (1,2). Procedures that reduce patient weight, including bariatric surgery, have demonstrated a beneficial effect in improving these symptoms (3). This study aimed to evaluate LUTS in patients undergoing bariatric surgery.

This study included patients with obesity who underwent bariatric surgery between March 2023 and August 2024 at a tertiary-level center. Comorbidities, body mass index (BMI), glucose, glycosylated hemoglobin (HbA1c), International Prostate Symptom Score (IPSS), and International Consultation on Incontinence Questionnaire for Lower Urinary Tract Symptoms and Quality of Life (ICIQ-LUTSqol) were assessed at baseline and at 3 and 6 months post-surgery. Data were compared using ANOVA and Friedman tests, with a significance threshold of p <0.05.

A total of 63 bariatric surgeries, all performed laparoscopically, were included. The majority of patients were female (n=47), with an average age of 43 (±10.5) years. Among these, 25 underwent gastric bypass, 19 underwent gastric sleeve, 2 underwent one-anastomosis gastric bypass (OAGB), and 1 underwent single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). The mean baseline weight was 112 (±15.6) kg, height 1.6 (±0.06) m, and BMI 43.7 (±6.3) kg/m². Median baseline blood glucose was 93 mg/dL (range: 72–230), and HbA1c was 5.7% (range: 4.9–10.7). Baseline IPSS had a median of 8 points, with mild symptoms in 40.4%, moderate in 53.2%, and severe in 6.4%. The voiding/storage (V/S) index showed a predominance of storage symptoms in 80.9%. Quality of life assessed by ICIQ-LUTSqol had a median score of 28 (range: 19-76). 

Among male patients (n=16), the average age was 46.19 (±10.65) years. Of these, 12 underwent gastric bypass, 2 underwent sleeve gastrectomy, 1 underwent OAGB, and 1 underwent SADI-S. The mean baseline weight was 153.6 (±32.2) kg, height 1.76 (±0.09) m, and BMI 49.6 (±9.6) kg/m². Median baseline blood glucose was 99 mg/dL (range: 79–227), and HbA1c was 5.9% (range: 4.8–8.6). Baseline IPSS had a median of 8.5 points, with mild symptoms in 31.3%, moderate in 62.5%, and severe in 6.3%. The V/S index showed a predominance of storage symptoms in 62.5%, while ICIQ-LUTSqol had a median score of 28.

A significant reduction was observed in BMI, IPSS, and ICIQ-LUTSqol scores in both genders at 3 and 6 months post-surgery. (Table 2)

Obesity is associated with lower urinary tract symptoms, with a predominance of storage symptoms. Bariatric surgery, regardless of the type of procedure, is associated with a reduction in BMI, glycosylated hemoglobin, and IPSS, as well as an improvement in quality of life as measured by ICIQ-LUTSqol.

Mondul, A. M., Giovannucci, E., & Platz, E. A. (2014). A prospective study of obesity, and the incidence and progression of lower urinary tract symptoms. The Journal of Urology, 191(3), 715–721.
Kim, J. K., Lee, Y. G., Han, K., & Han, J. H. (2021). Obesity, metabolic health, and urological disorders in adults: a nationwide population-based study. Scientific Reports, 11(1).
Valipour, R., Narouie, B., Dadpour, M., Torabinavid, P., Momeni, H., Radpour, N., … Emami, M. A. (2024). Impacts of bariatric surgery on improvement of incontinence among obese Asian women: A prospective study and literature review. Obesity Surgery, 34(5), 1425–1431.