Gastric Band Surgery Has Upside for Women, Downside for Men
Women who underwent gastric band surgery to lose weight reported significant improvements in urinary function and quality of life after the operation, according to a new study.
However, men undergoing the procedure did not enjoy the same significant urinary function improvements as the women. They also reported that erectile function was slightly worse after surgery, unlike studies following non-surgical weight loss where sexual function actually improved.
"Urinary incontinence is common in people who are very obese and this study shows that gastric band surgery did improve the majority of urinary problems in women, with the exception of urge incontinence," Ranasinghe said.
About 65 percent of the women and 24 percent of the men had some urinary incontinence before the surgery, and 83 percent had erection problems before surgery, Ranasinghe said.
"Gastric band surgery is increasingly being used to tackle the most severe cases of obesity, because carrying excess weight increases the risk of life-threatening conditions such as heart disease, high blood pressure and diabetes," Ranasinghe said. But it is still only done after non-surgical options like diet and exercise have failed, so there is limited data to show its effect on sexual and urinary function.
The researchers surveyed 176 patients -- 142 women and 34 men -- who had undergone laparoscopic gastric banding surgery (LGB) at the same center during the last 10 years. The average time that had elapsed since their surgery was just under 32 months. The women's average age was 48, and the men's was 53.
Weight loss following surgery was similar for both sexes, averaging about 50 pounds. However the women had a slightly higher BMI loss than the men (8.3 versus 7.5).
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Key findings of the study included:
- The women in the study reported that weight loss had led to significant improvements in their urinary problems. This may have been due to a reduction in intra-abdominal pressure, as soon as three to four months after surgery.
- Every kilogram that women lost led to a slight improvement in their quality of life score.
- Although women reported an overall improvement in urinary function, urge incontinence worsened. The researchers said, however, that this condition can be caused by a number of factors.
- The men in the study did not show any improvement when it came to urinary function. The researchers suggested that raised intra-abdominal pressure may not affect male urinary problems in the same way as females.
- Despite the men's significant weight-loss, the overall scores for erectile and orgasmic function declined over time. Age was not a factor in this reduction.
The finding that men's erection and orgasm problems worsened after surgery is at odds with the findings of other studies, that showed an improvement in sexual function after the surgery, the researchers said. A number of factors may have played a role in this decline, they said, for example, there is always a dip in sexual function after any form of surgery, due to psychological issues and fluctuating hormone levels. It is likely that sexual function will improve over time.
"It is clear from our study that further research is needed to investigate the effects of gastric band surgery on urinary and sexual function, as such problems can be very distressing and cause a number of health and quality of life issues for patients."
The study was published in the January issue of the journal BJUI.
