Patient-reported bowel and bladder function is not adversely impacted by bariatric surgery.

Area of Science:

• Gastroenterology and Surgical Outcomes
• Patient-Reported Outcome Measures (PROMs)
• Bariatric Surgery and Metabolic Health

Background:

• Concerns exist regarding the impact of bariatric surgery on bowel and bladder function.
• Understanding patient-reported outcomes is crucial for comprehensive surgical assessment.
• Previous studies have yielded mixed results on post-bariatric surgery functional changes.

Purpose of the Study:

• To evaluate the effect of bariatric surgery on patient-reported bowel and bladder function.
• To test the hypothesis that bariatric surgery does not negatively impact these functions.
• To identify factors associated with functional outcomes post-bariatric procedures.

Main Methods:

• Retrospective review of a prospectively maintained surgical quality database (2012-2020).
• Inclusion of patients undergoing primary bariatric surgery (n=573).
• Assessment using Surgical Outcomes Measurement System (SOMS) questionnaires pre-operatively and up to 2 years post-operatively; analyzed with mixed-effects models.

Main Results:

• Transient worsening of bowel function at 2 weeks post-op, followed by significant improvement by 3 months, sustained through 2 years.
• Immediate and sustained improvement in bladder function noted from 2 weeks to 1 year post-op.
• Sleeve gastrectomy patients showed greater bowel function improvement than gastric bypass patients at 1 year; greater total body weight loss (TBWL) correlated with improved bowel function.

Conclusions:

• Bariatric surgery does not worsen patient-reported bowel or bladder function.
• Overall improvement in bowel and bladder function is observed by 3 months post-surgery.
• Increased total body weight loss is significantly associated with enhanced bowel function post-bariatric surgery.