Breaking News
January 19, 2019 - New Leash on Life? Staying Slim Keeps Pooches Happy, Healthy
January 19, 2019 - Men and women remember pain differently
January 19, 2019 - Rising air pollution linked with increased ER visits for breathing problems
January 19, 2019 - Study uses local data to model food consumption patterns among Seattle residents
January 19, 2019 - The brain’s cerebellum plays role in controlling reward and social behaviors, study shows
January 19, 2019 - Relationship between nurse work environment and patient safety
January 19, 2019 - Pioneering surgery restores movement to children paralyzed by acute flaccid myelitis
January 19, 2019 - Genetic variants linked with risk tolerance and risky behaviors
January 19, 2019 - New research provides better understanding of our early human ancestors
January 19, 2019 - First-ever tailored reporting guidance to improve patient care and outcomes
January 19, 2019 - 4.6 percent of Massachusetts residents have opioid use disorder
January 19, 2019 - New study suggests vital exhaustion as risk factor for dementia
January 19, 2019 - New antibiotic discovery heralds breakthrough in the fight against drug-resistant bacteria
January 19, 2019 - Ural Federal University scientists synthesize a group of multi-purpose fluorophores
January 19, 2019 - Researchers identify new therapeutic target in the fight against chronic liver diseases
January 19, 2019 - Preparation, characterization of Soyasapogenol B loaded onto functionalized MWCNTs
January 19, 2019 - FDA Approves Ontruzant (trastuzumab-dttb), a Biosimilar to Herceptin
January 19, 2019 - Tobacco use linked with higher use of opioids and sedatives
January 19, 2019 - Study delves deeper into developmental dyslexia
January 19, 2019 - Anti-vaccination movement one of the top health threats in 2019 says WHO
January 19, 2019 - Newly developed risk score more effective at identifying type 1 diabetes
January 19, 2019 - Highly effective protocol to prepare cannabis samples for THC/CBD analysis
January 19, 2019 - Prinston Pharmaceutical Inc. Issues Voluntary Nationwide Recall of Irbesartan and Irbesartan HCTZ Tablets Due to Detection of a Trace Amount of Unexpected Impurity, N-Nitrosodiethylamine (NDEA) in the Products
January 19, 2019 - How does solid stress from brain tumors cause neuronal loss, neurologic dysfunction?
January 19, 2019 - $14.7 million partnership to supercharge vaccine development
January 19, 2019 - Ian Fotheringham receives Charles Tennant Memorial Lecture award
January 19, 2019 - Brain vital signs detect neurophysiological impairments in players with concussions
January 19, 2019 - Lack of job and poor housing conditions increased likelihood of people attending A&E
January 19, 2019 - Novel targeted drug delivery system improves conventional cancer treatments
January 19, 2019 - Rutgers study finds gene responsible for spread of prostate cancer
January 19, 2019 - Complications Higher Than Expected for Invasive Lung Tests
January 19, 2019 - 3-D printed implant promotes nerve cell growth to treat spinal cord injury
January 19, 2019 - Automated texts lead to improved outcomes after total knee or hip replacement surgery
January 19, 2019 - Poor cardiorespiratory fitness could increase risk of future heart attack, finds new study
January 19, 2019 - Drinking soft drinks while exercising in hot weather may increase risk of kidney disease
January 19, 2019 - Formlabs 3D prints anatomical models
January 19, 2019 - Heart-Healthy Living Also Wards Off Type 2 Diabetes
January 19, 2019 - Teaching Kids to Be Smart About Social Media (for Parents)
January 19, 2019 - Metabolite produced by gut microbiota from pomegranates reduces inflammatory bowel disease
January 19, 2019 - Researchers examine how spray from showers and toilets expose us to disease causing bacteria
January 19, 2019 - Behavioral experiments confirm that additional neurons improve brain function
January 19, 2019 - New study compares performance of real-time infectious disease forecasting models
January 19, 2019 - Obesity can be risk factor for developing renal cell carcinoma, confirms study
January 19, 2019 - New regulation designs on cigarette packs direct smokers’ attention to health warnings
January 19, 2019 - QIAGEN receives first companion diagnostic approval in Japan
January 19, 2019 - Study explores role of Dunning-Kruger effect in anti-vaccine attitudes
January 19, 2019 - Newly identified subset of immune cells may be key to fighting chronic inflammation
January 19, 2019 - New immune response regulators discovered
January 18, 2019 - Poor blood oxygenation during sleep predicts chance of heart-related death
January 18, 2019 - First international consensus on the diagnosis and management of fibromuscular dysplasia
January 18, 2019 - Rapid resistance gene sequencing technology can hasten identification of antibiotic-resistant bacteria
January 18, 2019 - Researchers develop artificial enzymatic pathway for synthesizing isoprenoids in E. coli
January 18, 2019 - Scientists advise caution in immunotherapy research
January 18, 2019 - How children across the world develop language
January 18, 2019 - Columbia Medical Student Receives McDonogh Scholarship
January 18, 2019 - Secretive ‘Rebate Trap’ Keeps Generic Drugs For Diabetes And Other Ills Out Of Reach
January 18, 2019 - Plant based diet could be the best option for the planet says commission
January 18, 2019 - New conservation practice could reduce nitrogen from agricultural drainage, study shows
January 18, 2019 - UIC researchers receive $1.7 million NCI grant to study Southeast Asian fruit
January 18, 2019 - New study determines the fate of DNA derived from genetically modified food
January 18, 2019 - Scientists develop new gene therapy that prevents axon destruction in mice
January 18, 2019 - Study finds critically low HPV vaccination rates among younger adolescents in the U.S.
January 18, 2019 - Brain cells involved in memory play key role in reducing future eating behavior
January 18, 2019 - Risk for Conversion of MS Varies With Different Therapies
January 18, 2019 - Investigational cream may help patients with inflammatory skin disease
January 18, 2019 - Medical school news office receives six writing awards | News Center
January 18, 2019 - County By County, Researchers Link Opioid Deaths To Drugmakers’ Marketing
January 18, 2019 - Research reveals risk for developing more than one mental health disorder
January 18, 2019 - Scientists discover a dramatic pattern of bone growth in female mice
January 18, 2019 - Study finds link between lengthy periods of undisturbed maternal sleep and stillbirths
January 18, 2019 - New nuclear medicine method could improve detection of primary and metastatic melanoma
January 18, 2019 - Combination therapy shows high efficacy in treating people with leishmaniasis and HIV
January 18, 2019 - Health Tip: Don’t Ignore Changes in Skin Color
January 18, 2019 - Dietary Recommendations for Healthy Children
January 18, 2019 - Eliminating the latent reservoir of HIV
January 18, 2019 - Pain From The Government Shutdown Spreads. This Time It’s Food Stamps
January 18, 2019 - Newly discovered regulatory mechanism helps control fat metabolism
January 18, 2019 - New rapid blood tests could speed up TB diagnosis, save the NHS money
January 18, 2019 - Researchers develop intelligent system for ‘tuning’ powered prosthetic knees
January 18, 2019 - Monoclonal antibody pembrolizumab prolongs survival in patients with squamous cell carcinoma
‘Tummy Tuck’ Relieved Postpartum Back Pain/Incontinence

‘Tummy Tuck’ Relieved Postpartum Back Pain/Incontinence

image_pdfDownload PDFimage_print

Action Points

  • Abdominoplasty (“tummy tuck”) with rectus muscle repair creates a significant improvement in the functional symptoms of low back pain and urinary incontinence, according to a prospective questionnaire study in 214 postpartum women.
  • Realize that abdominoplasty has long been considered only a cosmetic procedure, improving the shape of the abdomen by excess skin removal, liposuction, and rectus muscle plication, but these data show that any method of abdominoplasty produced similar restoration of prepartum function.

Abdominoplasty or a routine “tummy tuck” with rectus repair dramatically improved symptoms of back pain and urinary incontinence in a postpartum population, indicating that a cosmetic procedure can have functional benefits as well, a prospective, multicenter study showed.

At both 6 weeks and 6 months following the procedure, the 214 women who underwent some form of abdominoplasty had significant improvements in symptoms of low back pain and urinary incontinence, with very few having a slight worsening of symptoms postoperatively, reported Alastair Taylor, MD, of CAPS (Canberra Aesthetic Plastic Surgery) Clinic in Australia, and colleagues.

“Abdominoplasty has long been considered a cosmetic procedure, improving the shape of the abdomen by excess skin removal, liposuction, and rectus muscle plication,” the team wrote in Plastic and Reconstructive Surgery. “We found that all methods of abdominoplasty produced similar improvement. By restoring prepartum contour, it is also possible to restore prepartum function.”

For the study, patients were prospectively asked to fill in two questionnaires to assess the incidence of low back pain and urinary incontinence following the birth of a mean of 2.5 children. The mean age of the women was 42.1.

The mean body mass index (BMI) of the group was 26.3, and the mean number of normal vaginal deliveries was 1.5. The Oswestry Disability Index (ODI) was used to quantify low back pain while the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ) was used to assess the severity of incontinence. Most patients presented with both conditions, but some had just one or the other.

The methods of abdominoplasty used by the nine surgeons involved in the study were varied and included radical abdominoplasty, high-lateral-tension abdominoplasty, high-oblique-tension abdominoplasty, Fleur-de-lis, and mini-abdominoplasty.

The mean amount of weight removed during the procedure was 1,222 grams; mean fat volume removed during liposuction was 795 ml; and the mean diastasis was 4.5 cm, measured at the widest point intraoperatively. (Diastasis recti is a common occurrence in multiparous women and is caused by repeated stretching of the abdominal wall by the gravid uterus, the researchers explained).

A substantial proportion of patients also presented with hernias, which were also repaired during abdominoplasty.

Prior to surgery, the mean score on the ODI was 10.9. Six weeks after surgery, the mean score on the same index was 3.97, while at 6 months the mean score was 1.58 (P<0.001 for both time points). Similarly, the mean score on the ICIQ prior to surgery was 6.22, while 6 weeks after surgery the mean score was 1.63 and at 6 months, it was 1.60 (P<0.001 for both time points). Importantly, the severity of urinary incontinence also significantly improved, the investigators noted. Prior to the procedure, over 42% of the women rated their incontinence as being "a significant concern."

At 6 months postoperatively, just 1.8% of the women still rated their incontinence as significant: “Only a tiny number suffered a worsening of their symptoms, and even then, only minimally.”

Speculating on why abdominoplasty improved symptoms of back pain, Taylor et al wrote that they assumed that the improvement came about following restoration of the prepartum condition with plication of the diastasis and removal of excessive skin and fat — “As the anterior rectus distance is closed, function increases.”

This closure in turn restores certain muscles to their physiologic length, exerting tension on the lumbodorsal fascia and stabilizing the lumbar spine. “Abdominoplasty with rectus plication improves posture,” the researchers added. As for improvement in urinary symptoms, it may be that abdominoplasty increases strength in the anterior abdominal wall, making it possible to more completely empty the bladder.

Limitations to the study, the team said, include the fact that patients served as their own controls and that there was no randomization to any of the procedures used, since the surgeons chose which procedure they felt was most suitable for each patient.

Asked for his perspective, Rod Rohrich, MD, founding chair of the Department of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas, who was not involved with the study, said that patients have been telling him for years that when he does a tummy tuck, their back pain gets better.

“Of course we never tell patients that we are going to make their back pain better, but I have seen it very commonly, especially in women who’ve had multiple children.” What happens, he explained, is that after a woman has children, especially multiple children, the muscles of the abdominal cavity widen and weaken. “So that changes your back structure, and when we do a tummy tuck, we always bring together the rectus abdominis muscles, and that helps strengthen the back and makes it straight.

“What this study showed is that back pain did get significantly better with surgery, along with urinary incontinence, which is also very common with pregnancy,” he continued. “So this is the first study to my knowledge that validates in a scientific fashion that you truly do get improvement in back pain and urinary incontinence with a tummy tuck.”

The senior author of the study reported being a consultant to Allergan and owning stock in Strathspey Crown. Taylor and the other co-authors, as well as Rohrich, reported having no financial conflicts of interest.

2018-12-03T00:00:00-0500

last updated

About author

Related Articles