Breaking News
April 20, 2018 - FDA Alert: Certain Kratom-Containing Powder Products by Viable Solutions: Recall -Possible Salmonella Contamination
April 20, 2018 - What is heart failure?
April 20, 2018 - Inactivity of astronauts during spaceflights may have more pronounced effect on skeletal muscle than hypoxia
April 20, 2018 - New SIDS Info app seeks to reduce infant sleep-related deaths
April 20, 2018 - Wide-scale distribution of naloxone effectively prevents overdose deaths, study finds
April 20, 2018 - Triple-negative breast cancer found to be chemoresistant prior to treatment
April 20, 2018 - ACL tears occur the same way in women and men, study finds
April 20, 2018 - UT Southwestern researchers identify 170 potential therapeutic targets for lung cancer
April 20, 2018 - Finding the ‘keyhole’ to beat obesity at the cellular level
April 20, 2018 - Long-term exposure to cold temperatures reduces diabetes and obesity, shows study
April 20, 2018 - Metabolic Syndrome Common With Chronic Hep B Infection
April 20, 2018 - Tracking quality of life during prostate cancer treatment
April 20, 2018 - Study shows presence of beta-amyloid dimers in the brains of Alzheimer’s patients
April 20, 2018 - Researchers identify link between physical inactivity and increased risk of dying from cancer
April 20, 2018 - Breathtaking evolution amongst Indonesian tribe
April 20, 2018 - Study shows testosterone deficiency in men is associated with chronic diseases
April 20, 2018 - Simple one-page form helps improve satisfaction of patients with care
April 20, 2018 - Researchers evaluate accuracy of simple blood test to predict lung cancer
April 20, 2018 - Study looks at sperm producing ability in testicular cancer patients
April 20, 2018 - Exercise In, Vitamin D Out for Preventing Falls: U.S. Panel
April 20, 2018 - Skin cancers associated with decreased risk of developing AD
April 20, 2018 - Preserving fertility during chemotherapy
April 20, 2018 - Teva and Procter & Gamble Company terminate PGT Healthcare partnership
April 20, 2018 - People diagnosed with traumatic brain injury may have increased risk of Parkinson’s disease, shows study
April 20, 2018 - Researchers use smartphone to diagnose people infected with Loa loa worm
April 20, 2018 - College students with autism have high rate of suicidal thoughts
April 20, 2018 - Study sheds light on how the HSC niche is maintained
April 20, 2018 - Drug test spurs frank talk between hypertension patients and doctors
April 19, 2018 - Low-cost deworming drug improves female farmers’ physical fitness
April 19, 2018 - Genome editing identifies neural circuit behind leptin’s anti-obesity and anti-diabetes effects
April 19, 2018 - Many European countries lack comprehensive policy to eliminate viral hepatitis
April 19, 2018 - Young people with ADHD ‘more likely’ to come from deprived neighbourhoods
April 19, 2018 - SLU professor discovers new biomarkers for chlorine gas exposure
April 19, 2018 - Study proposes new mechanism that may contribute to gender differences in weight control
April 19, 2018 - Sleep restriction therapy does not interfere with insomnia patient’s driving ability, research shows
April 19, 2018 - Deep brain stimulation offers relief to UTHealth patient with treatment-resistant depression
April 19, 2018 - Study shows fatty fish and camelina oil boost HDL and IDL cholesterol
April 19, 2018 - FDA Alert: Euphoric Capsules by Epic Products: Recall
April 19, 2018 - Researchers identify peptide produced during cartilage deterioration as a potential source of osteoarthritis pain
April 19, 2018 - New breakthrough may allow scientists to orchestrate tissue regeneration in humans
April 19, 2018 - SYGNIS AG introduces new TruePrime apoptotic cell free DNA amplification kit
April 19, 2018 - Innovative device shows promise in capturing and releasing circulating tumor cells
April 19, 2018 - Researchers shed light on role of striosomal neurons in reinforcement learning
April 19, 2018 - Genetic make-up impacts long-term effectiveness of phobia treatment
April 19, 2018 - Novel biomarker can distinguish malignant lung nodules
April 19, 2018 - Study reports promising novel approach to treat therapy resistant pediatric brain tumors
April 19, 2018 - One-Hour Plasma Glucose Useful Predictor of Diabetic Retinopathy
April 19, 2018 - Hydroxychloroquine no more effective than placebo for relieving osteoarthritis hand pain
April 19, 2018 - Transplanted livers have a protective effect and reduce potential for organ rejection
April 19, 2018 - Researchers develop new method to study activity of inflammatory cells
April 19, 2018 - Researchers discover highly antibiotic resistant superbugs in Gulf States
April 19, 2018 - Smart-tooth technology shows promise in detecting certain diseases in high-risk patients
April 19, 2018 - Interaction between dioxin and HLA gene variant activates events associated with rheumatoid arthritis
April 19, 2018 - Eyes of adolescents could be associated with increased risk of cardiovascular disease in later life
April 19, 2018 - U.S. Women Less Likely Than Men to Get Statins After Heart Attack
April 19, 2018 - Health Canada grants cannabis cultivation license to High Park Farms
April 19, 2018 - Atypical brain development observed in preschoolers with ADHD symptoms
April 19, 2018 - SC Johnson releases annual Sustainability Report
April 19, 2018 - Positive attitudes about aging reduce risk of dementia in older adults
April 19, 2018 - Environmental pollutants found to worsen rheumatoid arthritis
April 19, 2018 - UT Southwestern scientists discover protein linked to metastatic breast cancer
April 19, 2018 - Study highlights need for further evidence to improve symptom management in end of life care
April 19, 2018 - Detecting diminished dopamine-firing cells inside brain could reveal earliest signs of Alzheimer’s
April 19, 2018 - Uniqsis offers high-power LED light unit for scalable flow photochemistry reactions
April 19, 2018 - Case study shows how intravascular ultrasound imaging helps detect acute aortic syndrome
April 19, 2018 - Research reveals new mechanism by which HIV evades the immune system
April 19, 2018 - Nanodisc-delivered cancer treatment helps eliminate tumors
April 19, 2018 - Functional connectivity MRI could help detect brain disorders and diseases
April 19, 2018 - Finding better way to quantify neuropathy symptoms and treatment efficacy
April 19, 2018 - Study examines effectiveness of caregiver education about sickle cell trait
April 19, 2018 - High-resolution images of tumor vasculature using new technology
April 19, 2018 - Lack of sleep may be linked to risk factor for Alzheimer’s disease
April 19, 2018 - Study finds neurotransmitter may play a role in alcohol relapse, addiction
April 19, 2018 - Researchers build molecular networks of calcific aortic valve disease
April 19, 2018 - Researchers develop highly specific apoptosis assay for pharmacodynamic analyses of tumor specimens
April 19, 2018 - Scientists decipher mechanism of chemotherapy induced female infertility
April 19, 2018 - New insight may allow researchers to design drugs that improve immune responses to vaccines
April 19, 2018 - FDA Approves Crysvita (burosumab-twza) for X-Linked Hypophosphatemia
April 19, 2018 - Researchers uncover origin of virus-fighting plasma B cells
April 19, 2018 - Study finds no evidence of lower intelligence in young children who had anesthesia
‘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