An Added, Unexpected and Welcome Medical Benefit of a Tummy Tuck
Stress Urinary Incontinence (SUI) is a common type of bladder control problem in women characterized by uncontrollable leakage of urine with increased abdominal pressure. It is triggered by physical activities such as coughing, sneezing, exercise and laughing. Postpartum stress urinary incontinence can occur even among women who have given birth to only one child. It is an important and often overlooked post-pregnancy condition common in women who’ve had a vaginal delivery.
Surgical treatments currently available involve the application of a tension-free vaginal mesh tape to provide support for a sagging urethra so that when you cough or move vigorously or suddenly, the urethra can remain closed with no accidental release of urine.
However, results from several studies have suggested a tummy tuck, also known as an abdominoplasty, could be therapeutic for certain individuals with urinary incontinence. A tummy tuck is a surgical procedure designed to flatten the abdomen by removing loose skin and/or excess fat and tighten muscles in the abdominal wall. This is often part of a “mommy makeover”, a moniker given to procedures, invasive and non-invasive, many women opt for to regain their pre-pregnancy figure.
My colleagues and I recently conducted a study to determine the potential therapeutic effect of a tummy tuck on patients with postpartum stress urinary incontinence to confirm the findings of smaller studies. We also wanted to identify common characteristics of patients who experience the greatest improvement in these symptoms following a tummy tuck procedure.
We found that a tummy tuck significantly alleviated the symptoms of stress urinary incontinence in 60% of our patients, especially in patients who hadn’t undergone previous cesarean section. In some abdominoplasty procedures where we pull up sufficient soft tissue in the pelvic area, we may get enough of a pull to suspend the urethra, creating a slight bladder outlet obstruction to reduce incontinence.
Last month, the American College of Physicians released new guidelines for urinary incontinence that might also be worth looking into. The guidelines recommend Kegel exercises to strengthen pelvic floor muscles, weight loss, bladder training and medication for women with urgency incontinence.
More research needs to be conducted to identify which patients would benefit at all, a little or substantially from a tummy tuck procedure to aid stress urinary incontinence.