Can Abdominoplasty Relieve Symptoms of Urinary Incontinence?

[INTRODUCTION] Urinary incontinence is a debilitating condition often affecting women after pregnancy or significant weight change. Abdominoplasty is an aesthetic and functional operation often performed in an overlapping cohort. Functional benefits of abdominoplasty include improvements in back pain, urinary incontinence and psychosocial well-being. However, current literature regarding this effect on urinary incontinence is limited. We systematically review the literature to determine the effect of abdominoplasty on urinary incontinence.

[METHODS] A systematic review of the literature was performed by searching MEDLINE (1946-present) and EMBASE (1974-present) databases, using the terms "abdominoplasty" OR "panniculectomy" AND "incontinence". Full-length manuscripts were then appraised after selection, and data extracted for analysis.

[RESULTS] Thirteen studies encompassing 719 patients were included. Mean age was 43.48 years, with 710 females and 9 males. Mean BMI was 28.94; rate of previous pregnancy when reported was 93.20%. Rectus plication was performed in 91.31%, and mean excisional weight was 1498.53g. Rate of preoperative urinary incontinence was 72.81%, whilst post-operative was 38.88%, representing a reduction in the rate of urinary incontinence of 46.60%. Change in urinary continence was described as improved, the same or worse based on each study's available data. Improvement was reported in 54.98%, the same was reported in 35.17%, and worse was reported in 6.80%. Mean follow-up was 26.92 months.

[CONCLUSION] Abdominoplasty can be associated with life-altering functional benefits. Urinary incontinence is one such benefit that has been generally under-recognised. We provide to our knowledge the largest cumulative data set that demonstrates this effect.

[LEVEL OF EVIDENCE V] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .