Abdominoplasty Improves Low Back Pain and Urinary Incontinence

Taylor, D. Alastair; Merten, Steven; Sandercoe, Gavin D.; Gahankari, Dilip; Ingram, Scott B.; Moncrieff, Nicholas J.; Ho, Kevin; Sellars, Graham D.; Magnusson, Mark

doi:10.1097/prs.0000000000004100

Cited by 32 publications

(31 citation statements)

References 33 publications

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“…The improvement in urinary incontinence symptoms observed in this study is in line with previous studies 26 , and may indicate a correlation between abdominal trunk instability and pelvic floor dysfunction. Higher preoperative UDI-6 scores resulted in greater improvements in urinary incontinence symptoms after surgery, suggesting that patients with severe symptoms benefit more from surgical reconstruction than those with mild symptoms -an important factor when selecting patients for surgery.…”

Section: Discussionsupporting

confidence: 92%

“…There is no strong evidence that training during pregnancy and in the postpartum period decreases the risk of persistent DRA, although some studies have reported that specific exercises could increase abdominal trunk stability and reduce some of the associated symptoms. Surgical reconstruction has been reported to restore abdominal trunk function and improve lower back pain and urinary incontinence. General awareness of symptomatic DRA is poor, and patients are commonly advised to undertake non‐specific physical training, or told that the condition is only cosmetic in nature.…”

Section: Introductionmentioning

confidence: 99%

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Cohort study of the effect of surgical repair of symptomatic diastasis recti abdominis on abdominal trunk function and quality of life

et al. 2019

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BackgroundDuring pregnancy, women are at risk of developing persistent symptomatic diastasis recti abdominis (DRA), which may have a detrimental effect on their physical function and quality of life (QoL). The aim of this prospective cohort study was to determine the effect of surgical repair of DRA on abdominal trunk function, urinary incontinence and QoL in postpartum women with trunk instability symptoms resistant to training.MethodsPostpartum women with diagnosed DRA and training‐resistant symptoms underwent double‐row plication of the linea alba. Abdominal trunk function was evaluated as the primary endpoint using a multimodal examination tool, the Abdominal Trunk Function Protocol. Recurrence was assessed by CT, urinary incontinence was evaluated using the Urogenital Distress Inventory (UDI‐6) and Incontinence Impact Questionnaire (IIQ‐7), and QoL was assessed with the Short Form 36 (SF‐36®) questionnaire. All subjects were examined before and 1 year after surgery.ResultsSixty women were recruited. There was no DRA recurrence at the 1‐year follow‐up. Self‐reported abdominal trunk function had improved in 98 per cent of patients, with a mean score improvement of 79·1 per cent. In the physiological tests monitored by a physiotherapist, 76 per cent performed better and endured exercise tests longer than before surgery. All SF‐36® subscales improved significantly compared with preoperative scores and reached levels similar to, or higher than, the normative Swedish female population. For the UDI‐6 and IIQ‐7, 47 and 37 per cent respectively reported fewer symptoms at follow‐up than before surgery, and 13 and 8 per cent respectively reported more symptoms.ConclusionIn this series of postpartum women presenting with DRA and symptoms of trunk instability resistant to training, surgical reconstruction resulted in a significant improvement in abdominal trunk function, urinary incontinence and QoL.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Cohort study of the effect of surgical repair of symptomatic diastasis recti abdominis on abdominal trunk function and quality of life

et al. 2019

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“… 4 , 5 , 11 , 12 More recently, studies have demonstrated similar clinical and radiographic improvements in patients undergoing abdominoplasty with limited rectus plication. 3 , 13 A recent prospective, multicenter study showed improvement in both chronic back pain and urinary incontinence following abdominoplasty with a variety of different limited plication techniques in postpartum females. 13 Contrary to earlier studies, current literature suggests that a limited plication can improve vertebral angles and relieve pressure on the spine, while avoiding the potential complications of abdominoplasty with wide plication previously described.…”

Section: Discussionmentioning

confidence: 99%

Improvement in Back Pain Following Abdominoplasty: Results of a 10-Year, Single-Surgeon Series

Soteropulos

Edinger

Leibl

et al. 2020

Aesthetic Surgery Journal

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Background Few studies have examined the impact of abdominoplasty on chronic back pain. Objectives The aim of this study was to test our hypothesis that patients undergoing abdominoplasty with anterior abdominal wall plication will show significant improvements in back pain and physical function compared with those without plication. Methods We utilized Current Procedural Terminology (CPT) codes to identify patients who underwent abdominoplasty with the senior author over a 10-year period. The Oswestry Disability Index (ODI) and the RAND 36-Item Short-Form Health Survey (SF-36) were administered. All patients indicating preoperative back pain were reviewed. Results Of 338 patients, 143 surveys (42.3%) were returned; 51 patients (35.7%; n = 28 aesthetic, n = 23 massive weight loss) reported preoperative back pain on the ODI. Paired t tests compared overall and strata-specific changes in ODI and SF-36 pre- and postsurgery. Multivariable linear regression models were fitted to model relations between scores and plication, adjusting for presurgery scores and patient variables. There were significant improvements in overall patient cohort in ODI (–15.14), SF-36 physical function (19.92), and pain (17.42) (P < 0.001), as well as when patients were stratified by plication status. However, outcomes between those with plication and those without were not significantly different. Conclusions Abdominoplasty with and without anterior abdominal wall plication significantly improves ODI and SF-36 scores relating to physical function and pain, in both aesthetic and massive weight loss patients. Outcomes did not differ based on plication status. All patients with preoperative back pain showed improvement regardless of operation performed, suggesting that abdominoplasty with or without abdominal wall plication improves chronic back pain in this patient population. Level of Evidence: 4

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“…Ambos trabajos, si bien demostraron una mejora de la incontinencia, fueron trabajos retrospectivos que utilizaron cuestionarios no validados y con un número bajo de pacientes. En un estudio prospectivo y multicéntrico realizado en 2018 en Australia, liderado por Taylor 31 34 realizó otro estudio prospectivo para evaluar la efi cacia a largo plazo de la corrección de la diastasis utilizando Nylon 2.0. En este estudio, la muestra fue de 12 pacientes de entre 18 y 52 años sometidas a abdominoplastia, en las que se utilizó para la sutura de los rectos Nylon 2.0 en dos planos.…”

Section: Clasificaciónunclassified

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2020

RACP

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Abdominoplasty Improves Low Back Pain and Urinary Incontinence

Abstract: Therapeutic, IV.

Cited by 32 publications

References 33 publications

Cohort study of the effect of surgical repair of symptomatic diastasis recti abdominis on abdominal trunk function and quality of life

Cohort study of the effect of surgical repair of symptomatic diastasis recti abdominis on abdominal trunk function and quality of life

Improvement in Back Pain Following Abdominoplasty: Results of a 10-Year, Single-Surgeon Series

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