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International Urogynecology Journal

Published in:

01-08-2012 | Original Article

Impact of surgically induced weight loss on pelvic floor disorders

Authors: Emily L. Whitcomb, Santiago Horgan, Michael C. Donohue, Emily S. Lukacz

Published in: International Urogynecology Journal | Issue 8/2012

Abstract

Introduction and hypothesis

Given the increased prevalence of obesity and pelvic floor disorders (PFDs), we estimated changes in prevalence, bother, and quality of life (QOL) for PFDs in obese women undergoing bariatric surgery. We hypothesized PFDs would improve after surgical weight loss.

Methods

The prevalence, bother, and QOL impact of PFDs were estimated using validated measures. McNemar’s and paired t tests were used to compare pre- and postprocedural outcomes. Power calculations deemed that 90 individuals would achieve at least 80 % power to detect a decrease in prevalence of 12 %.

Results

The baseline mean (± standard deviation) age and body mass index (BMI) of the 98 women were 43.3 ± 11.8 years and 39.7 ± 6.2 kg/m.² BMI decreased to 34.4 ± 5.8 at 6 months and 34.0 ± 5.6 at 12 months. Whereas the overall prevalence of stress urinary incontinence (SUI) decreased from 22/69 (32 %) at baseline to 10/69 (15 %) at 6 months (p = 0.006) and 14/69 (20 %) at 12 months (p = 0.027), there were no significant decreases in overall prevalence of other PFDs. However, for women with SUI, overactive bladder (OAB), and anal incontinence at baseline, 11/23 (48 %), 8/11 (73 %) and 4/20 (20 %) resolved at 12 months, respectively. Pelvic Floor Impact Questionnaire scores decreased from baseline to 12 months (p < 0.001). Mean visual analog scores for women with SUI, OAB, and anal incontinence decreased at 12 months.

Conclusions

Surgical weight loss resulted in resolution of symptoms in nearly half of women with SUI and three quarters of women with OAB and was associated with significant improvement in QOL.

Organization WH. Obesity and overweight. Available at: http://wwwwhoint/dietphysicalactivity/publications/facts/obesity/en/ Accessed November 8, 2010

Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS et al (2003) Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 289(1):76–9PubMedCrossRef

Wu JM, Hundley AF, Fulton RG, Myers ER (2009) Forecasting the prevalence of pelvic floor disorders in U.S. Women: 2010 to 2050. Obstet Gynecol 114(6):1278–83PubMedCrossRef

Control CfD. Obesity epidemic increases dramatically in the United States: CDC director calls for national prevention effort. Available at: http://wwwcdcgov/od/oc/media/pressrel/r991026htm Accessed November 8, 2010

Sung VW, Washington B, Raker CA. Costs of ambulatory care related to female pelvic floor disorders in the United States. Am J Obstet Gynecol May;202(5):483 e1-4

Grimby A, Milsom I, Molander U, Wiklund I, Ekelund P (1993) The influence of urinary incontinence on the quality of life of elderly women. Age Ageing 22(2):82–9PubMedCrossRef

Hunskaar S, Vinsnes A (1991) The quality of life in women with urinary incontinence as measured by the sickness impact profile. J Am Geriatr Soc 39(4):378–82PubMed

Brown JS, Grady D, Ouslander JG, Herzog AR, Varner RE, Posner SF (1999) Prevalence of urinary incontinence and associated risk factors in postmenopausal women. Heart & Estrogen/Progestin Replacement Study (HERS) Research Group. Obstet Gynecol 94(1):66–70PubMedCrossRef

Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S (2003) Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG 110(3):247–54PubMedCrossRef

10.

Brown JS, Seeley DG, Fong J, Black DM, Ensrud KE, Grady D (1996) Urinary incontinence in older women: who is at risk? Study of Osteoporotic Fractures Research Group. Obstet Gynecol 87(5 Pt 1):715–21PubMedCrossRef

11.

Subak LL, Johnson C, Whitcomb E, Boban D, Saxton J, Brown JS (2002) Does weight loss improve incontinence in moderately obese women? Int Urogynecol J Pelvic Floor Dysfunct 13(1):40–3PubMedCrossRef

12.

Cuicchi D, Lombardi R, Cariani S, Leuratti L, Lecce F, Cola B. Clinical and instrumental evaluation of pelvic floor disorders before and after bariatric surgery in obese women. Surg Obes Relat Dis Aug 28

13.

Lukacz ES, Lawrence JM, Buckwalter JG, Burchette RJ, Nager CW, Luber KM (2005) Epidemiology of prolapse and incontinence questionnaire: validation of a new epidemiologic survey. Int Urogynecol J Pelvic Floor Dysfunct 16(4):272–84, Jul-AugPubMedCrossRef

14.

Barber MD, Kuchibhatla MN, Pieper CF, Bump RC (2001) Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185(6):1388–95PubMedCrossRef

15.

Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG et al (1999) Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Dis Colon Rectum 42(12):1525–32PubMedCrossRef

16.

Rogers RG, Coates KW, Kammerer-Doak D, Khalsa S, Qualls C (2003) A short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Int Urogynecol J Pelvic Floor Dysfunct 14(3):164–8, discussion 8PubMedCrossRef

17.

Stewart AL, Hays RD, Ware JE Jr (1988) The MOS short-form general health survey. Reliability and validity in a patient population. Med Care 26(7):724–35PubMedCrossRef

18.

Furlanetto LM, Mendlowicz MV, Bueno JR (2005) The validity of the Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients. J Affect Disord 86(1):87–91PubMedCrossRef

19.

Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R et al (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26(2):191–208, Apr-JunPubMedCrossRef

20.

Lukacz ES, Lawrence JM, Contreras R, Nager CW, Luber KM (2006) Parity, mode of delivery, and pelvic floor disorders. Obstet Gynecol 107(6):1253–60PubMedCrossRef

21.

Zeger SLaL, K.Y. (1986) Longitudinal data analysis for discrete and continuous outcomes. Biometrics 42:121-30

22.

Burgio KL, Richter HE, Clements RH, Redden DT, Goode PS (2007) Changes in urinary and fecal incontinence symptoms with weight loss surgery in morbidly obese women. Obstet Gynecol 110(5):1034–40PubMedCrossRef

23.

Wasserberg N, Petrone P, Haney M, Crookes PF, Kaufman HS (2009) Effect of surgically induced weight loss on pelvic floor disorders in morbidly obese women. Ann Surg 249(1):72–6PubMedCrossRef

Title: Impact of surgically induced weight loss on pelvic floor disorders
Authors: Emily L. Whitcomb
Santiago Horgan
Michael C. Donohue
Emily S. Lukacz
Publication date: 01-08-2012
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 8/2012
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-012-1756-5

ACC 2024 Congress

Springer Medicine

Impact of surgically induced weight loss on pelvic floor disorders

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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