One of the most common body contouring operations after pregnancies and significant weight loss is the abdominoplasty or tummy tuck. The known benefits of tummy tucks lie in the change they bring to the shape of the abdomen and waistline. If the abdominal tissue cut out is big enough, patients may also see improvement in back pain and skin hygiene in the groin creases. One of the other potential benefits for some patients that has been reported in several small studies is an improvement in urinary incontinence.
In the September issue of the Aesthetic Surgery Journal a study was published entitled ‘Improvement in Stress Urinary Incontinence after Abdominoplasty’. In this paper 250 women who underwent tummy tuck surgery were evaluated after surgery for urinary incontinence (UI) symptoms by survey. Only 100 patients (40%) completed the survey. Of these 100 patients, 60% reported an improvement in their UI symptoms while the other 40% did not. Lack of having had a prior c-section was the one factor identified that was a good predictor of improvement in UI symptoms after tummy tuck surgery.
How a tummy tuck may improve UI is speculative but it could be surmised that the relief of the pressure of excess abdominal tissue pressing down on the bladder is a contributing factor. It could also be that elevation of the pubic mound as result of the tummy tuck affects the urethral sphincter favorably. There is very scant discussion in the medical literature about any correlation between UI and abdominal contouring surgery so the exact mechanism of how the improvement occurs is not yet known.
This study, while not proving a decisive link between abdominoplasty and UI improvement, is strongly suggestive. A 60% stated improvement by patients indicates that it is more than just an infrequent occurrence. Since not all patients who had UI symptoms before surgery got improvement, it would be important to figure out whom is most likely to do so. This would be beneficial for UI patients who may avoid the need for other treatments if a tummy tuck is done first.
Dr. Barry Eppley
Indianapolis, Indiana