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Abdominoplasty Improves Low Back Pain and Urinary Incontinence

Taylor, D. Alastair, F.R.A.C.S.(Plast.); Merten, Steven L., F.R.A.C.S.(Plast.); Sandercoe, Gavin D., F.R.A.C.S.(Plast.); Gahankari, Dilip, F.R.C.S.(Ed.), F.R.A.C.S.(Plast.); Ingram, Scott B., F.R.A.C.S.(Plast.); Moncrieff, Nicholas J., F.R.A.C.S.(Plast.); Ho, Kevin, F.R.A.C.S.(Plast.); Sellars, Graham D., F.R.A.C.S.(Plast.); Magnusson, Mark R., F.R.A.C.S.(Plast.)

Plastic and Reconstructive Surgery: March 2018 - Volume 141 - Issue 3 - p 637–645
doi: 10.1097/PRS.0000000000004100
Cosmetic: Original Articles
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Background: The authors studied the incidence of low back pain and urinary incontinence in the postpartum population presenting for abdominoplasty, and the extent of improvement following the operation.

Methods: This multicenter prospective study used validated questionnaires: the Oswestry Disability Index for back pain and the International Consultation on Incontinence Questionnaire–Urinary Incontinence–Short Form for urinary incontinence. Questionnaires were administered preoperatively and at 6 weeks and 6 months postoperatively.

Results: Results cover 214 patients from nine centers. The mean age was 42.1 years, the mean parity was 2.5, and the mean body mass index was 26.3 kg/m2. The mean surgical statistics were as follows: weight removed, 1222 g; liposuction volume, 795 ml; and diastasis, 4.5 cm. Eighty-seven percent of the abdominoplasties were either radical, high lateral tension, or high oblique tension. The mean Oswestry Disability Index score preoperatively was 21.6 percent, and 8.8 percent had no back pain. The mean score was 8 percent at 6 weeks and 3.2 percent at 6 months. These results are statistically significant. The mean International Consultation on Incontinence Questionnaire score preoperatively was 6.5; of the patients assessed, 27.5 percent had no incontinence. This score fell to 1.6 at 6 weeks, and the same, 1.6, at 6 months. These results are also statistically significant. Preoperative predictors of back pain were body mass index greater than 25 kg/m2 and umbilical hernia; predictors of incontinence were age older than 40 years and vaginal deliveries. There were no significant predictors of postoperative back pain or urinary incontinence improvement at 6 months. All methods of abdominoplasty produced similar improvement.

Conclusion: Abdominoplasty with rectus repair creates a significant improvement in the functional symptoms of low back pain and urinary incontinence.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Deakin, Canberra, Australian Capital Territory; Sydney, Liverpool, Newcastle, Randwick, and Wahroonga, New South Wales; and Gold Coast, Brisbane, and Toowoomba, Queensland, Australia

From the CAPS Clinic; Macquarie University; Norwest Private Hospital, Bella Vista, Liverpool Hospital; VMO, Gold Coast University Hospital; University of Queensland; Hunter Plastic Surgery; the Department of Plastic Surgery, Prince of Wales and Sydney Children’s Hospital; Sydney Adventist Hospital; and Toowoomba Plastic Surgery.

Received for publication May 14, 2017; accepted September 14, 2017.

This trial is registered under the name “Functional Improvement with Abdominoplasty,” ClinicalTrials.gov identification number NCT03143959 (https://clinicaltrials.gov/ct2/show/NCT03143959).

Presented at the 39th Annual Meeting of the Australasian Society of Aesthetic Plastic Surgeons, in Gold Coast, Queensland, Australia, October 6 through 9, 2016.

Disclosure: Dr. Magnusson is a consultant to Allergan and owns stock in Strathspey Crown. Drs. Taylor, Gahankari, Ho, Ingram, Merten, Moncrieff, Sandercoe, and Sellars have no financial interest to disclose.

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to PRSJournal.com and click on “Plastic Surgery Hot Topics” in the “Digital Media” tab to watch. On the iPad, tap on the Hot Topics icon.

D. Alastair Taylor, F.R.A.C.S.(Plast.), The CAPS Clinic, 7 Phipps Close, Deakin, Canberra, Australian Capital Territory 2600, Australia, alastair@capsclinic.com.au

©2018American Society of Plastic Surgeons