Share this article on:

The Effect of Abdominoplasty on Urinary Incontinence in Women

Solanki, Nicholas S. B.M.B.S., B.Sc.; Duffield, Jaime A. Ph.D., B.Sc.(Hons.); Dean, Nicola R. F.R.C.S.(Eng.), Ph.D.; Morgan, R. Gwyn F.R.C.S., F.A.C.S.

Plastic and Reconstructive Surgery: October 2010 - Volume 126 - Issue 4 - p 206e-209e
doi: 10.1097/PRS.0b013e3181ea9372

Department of Plastic and Reconstructive Surgery; Flinders Medical Centre; Bedford Park, South Australia, Australia

Correspondence to Dr. Solanki; Department of Plastic and Reconstructive Surgery; Flinders Medical Centre; Bedford Park, South Australia 5042, Australia;

Presented at the Flinders Medical Center Research Day, in Adelaide, South Australia, Australia, August 3, 2009.

Back to Top | Article Outline


Urinary incontinence has a significant psychosocial, economic, and health impact on the Australian community.1 In 2006, the prevalence of incontinence in Australian women was estimated to be as high as 37 percent1 and in 1998 was thought to cost the community $710 million in treatment and personal costs.2 Current treatments for female incontinence include pelvic floor exercises, medication, and surgery. The current literature on the effect of abdominoplasty on urinary incontinence consists of three case reports.3–5 These were all single case reports of middle-aged female patients who subjectively reported improved urologic function postoperatively. The proposed mechanism in all cases was an increase in intraabdominal pressure and muscle stabilization by plicating the rectus sheath, which facilitated improved bladder emptying. We hypothesized that women with urinary incontinence symptoms may have improvement following abdominoplasty.

We performed a retrospective postal questionnaire–based study of a population of women who had undergone abdominoplasty at either Flinders Medical Centre or the private rooms of the senior author (R.G.M.) between January of 2005 and March of 2009. Any patient that had undergone previous urologic surgery was excluded. Data were also collected from the medical records. As no previously validated questionnaire existed for such a retrospective study, one was devised by the study group (Fig. 1). The questionnaire consisted of a series of questions asking the patient to grade her symptoms using a Likert scale. These questions were designed to assess symptoms of urinary incontinence before and after abdominoplasty. Results were tested for significance using the unpaired t test and the chi-square test. Patients were grouped together for the purposes of analysis.

Fig. 1.

Fig. 1.

In our population of 100 patients who underwent abdominoplasty, the median age was 42.7 years (range, 14.2 to 77.5 years), with a mean weight of 76.0 kg (range, 40 to 120 kg) and a mean body mass index of 28.9 (range, 20.5 to 42.9). The main indication for abdominoplasty was localized adiposity (82.8 percent). The group reporting incontinence symptoms had undergone fewer cesarean deliveries (p = 0.005, t test). None of the other variables was significant. Forty-six patients replied to the questionnaire, of which 59.0 percent reported incontinence symptoms preoperatively. Of these patients, 25.9 percent reported improvement of symptoms, 3.7 percent reported worsening of symptoms, and the rest reported no change during the 6 months postoperatively (Fig. 2).

Fig. 2.

Fig. 2.

This study was conducted in a population of middle-aged women with medium to high body mass indexes who underwent abdominoplasty for mainly aesthetic reasons. The majority of these patients had previously had children, and a number had undergone significant weight loss. This is a population already known to have a high rate of urinary incontinence. The key finding of our study was that 25.9 percent of patients undergoing abdominoplasty who had symptoms of urinary incontinence reported an improvement in these symptoms postoperatively. The strength of this study is affected by several drawbacks, which include the use of a nonvalidated questionnaire, a small population size, and the retrospective nature of the study. However, despite this, it still indicates that abdominoplasty may have a beneficial effect on the symptoms of urinary incontinence in this population, and it is a field worthy of further prospective study.

Back to Top | Article Outline


The authors have no conflicts of interest to disclose.

Nicholas S. Solanki, B.M.B.S., B.Sc.

Jaime A. Duffield, Ph.D., B.Sc.(Hons.)

Nicola R. Dean, F.R.C.S.(Eng.), Ph.D.

R. Gwyn Morgan, F.R.C.S., F.A.C.S.

Department of Plastic and Reconstructive Surgery

Flinders Medical Centre

Bedford Park, South Australia, Australia

Back to Top | Article Outline


1.Australian Institute of Health and Welfare. Australian Incontinence Data Analysis and Development. AIHW cat. no. DIS 44. Canberra: Australian Institute of Health and Welfare; 2006.
2.Doran CM, Chiarelli P, Cockburn J. Economic cost of urinary incontinence in community-dwelling Australian women. Med J Aust. 2001;174:456–458.
3.Widgerow AD. Abdominoplasty following colostomy. Ann Plast Surg. 1992;298:454–456.
4.Güneren E, Eroğlu L, Koçak I, Uysal OA. Urinary incontinence was improved after abdominoplasty using a very low incision. Plast Reconstr Surg. 1999;104:1582–1584.
5.Mast BA. Alleviation of urinary incontinence after abdominoplasty. Ann Plast Surg. 1999;42:456–457.
Back to Top | Article Outline

Section Description


Viewpoints, pertaining to issues of general interest, are welcome, even if they are not related to items previously published. Viewpoints may present unique techniques, brief technology updates, technical notes, and so on. Viewpoints will be published on a space-available basis because they are typically less time sensitive than Letters and other types of articles. Please note the following criteria:

Authors will be listed in the order in which they appear in the submission. Viewpoints should be submitted electronically via PRS' enkwell, at We strongly encourage authors to submit figures in color.

We reserve the right to edit Viewpoints to meet requirements of space and format. Any financial interests relevant to the content must be disclosed. Submission of a Viewpoint constitutes permission for the American Society of Plastic Surgeons and its licensees and assignees to publish it in the Journal and in any other form or medium.

The views, opinions, and conclusions expressed in the Viewpoints represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.

©2010American Society of Plastic Surgeons