Can a Tummy Tuck Cure Incontinence?

Relief from stress urinary incontinence may be an underappreciated additive benefit following abdominoplasty, according to a new study in the September issue of the Aesthetic Surgery Journal.

After abdominoplasty, 60% of patients noted improvement in their incontinence symptoms, and the other 40% reported no improvement. Lack of previous Cesarean section was a predictor of improvement in stress urinary incontinence symptoms after abdominoplasty.

Researchers studied postoperative changes in 250 women with stress urinary incontinence who underwent cosmetic abdominoplasty. Patients were subgrouped according to postoperative changes in their urinary incontinence symptoms, and the subgroups were then evaluated for common within-group characteristics. Of the 250 patients who underwent abdominoplasty in the study, 40% completed the survey, half of whom reported incontinence preoperatively. After abdominoplasty, 60% of these patients noted improvement in their symptoms, and the other 40% reported no improvement. Lack of previous Cesarean section was a predictor of improvement in stress urinary incontinence symptoms after abdominoplasty.

“There is very little in the literature about this phenomenon” says study author James D. McMahan, MD, a plastic surgeon in Columbus, Ohio.

The impetus for the study was a patient’s candid remarks during a postabdominoplasty follow-up visit, he says. “She said she no longer had leakage after laughing or coughing,” he recalls.

The motto of this story? “It’s always a good idea to listen to your patients.”

Exactly how or why the surgery improves urinary incontinence is not fully understood, but theories exist. For example, “in some of the abdominoplasty procedures where we pull up on the skin, we may get enough of a pull on the urethra to reduce hypermobility and incontinence,” he says.

The next step may be an urodynamic study to further delineate who can expect this improvement following tummy tuck. “If we could better identify who would benefit in advance, and they are considering having a procedure to treat incontinence and a tummy tuck, it may behoove them to have the tummy tuck first and see what happens.”

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