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International Urogynecology Journal
Published in: International Urogynecology Journal 9/2014

01-09-2014 | Original Article

The improvement in pelvic floor symptoms with weight loss in obese women does not correlate with the changes in pelvic anatomy

Authors: Yavuz M. Gozukara, Gulcan Akalan, Ekrem C. Tok, Hakan Aytan, Devrim Ertunc

Published in: International Urogynecology Journal | Issue 9/2014

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Abstract

Introduction and hypothesis

It has been suggested that weight reduction decreases the frequency of urinary incontinence (UI) episodes. However, it is not known if this improvement is associated with anatomical changes in the pelvis. The aim of this study was to investigate the effects of weight loss on UI episodes and pelvic floor anatomy.

Methods

Three hundred seventy-eight overweight/obese women were randomly allocated either to behavioral weight loss or to structured education programs. The patients were evaluated by voiding diary, Pelvic Floor Distress Inventory (PFDI), and Pelvic Organ Prolapse Quantification (POP-Q) system at baseline and after 6 months.

Results

The women in the intervention group had a mean weight loss of 9.4 %, whereas the weight in the control group remained almost the same (P < 0.001). While there were no change in stress and urge incontinence episodes in the control group, the mean number of stress incontinence episodes per 3-day diary dropped from 7.96 episodes to 3.11, and the mean number of urge incontinence episodes per 3-day diary dropped from 2.85 episodes to 1.08 in the study group (P < 0.05). Regarding the POP-Q system, only genital hiatus, perineal body, and Ap measurements were significantly lower in the weight loss group than in the control group after 6 months.

Conclusions

Weight reduction provides improvement in episodes of UI, decreases the incidence of drops of urine leakage, and increases quality of life related to pelvic floor symptoms. However, there are little to no changes in the parameters of the POP-Q system with weight reduction.
Literature
1.
Elving LB, Foldspang A, Lam GW et al (1989) Descriptive epidemiology of urinary incontinence in 3,100 women age 30–59. Scand J Urol Nephrol Suppl 125:37–43PubMed
2.
Brown JS, Grady D, Ouslander JG et al (1999) Prevalence of urinary incontinence and associated risk factors in postmenopausal women. Heart and Estrogen/Progestin Replacement Study (HERS) Research Group. Obstet Gynecol 94:66–70PubMedCrossRef
3.
Ertunc D, Tok EC, Pata O, Dilek U, Ozdemir G, Dilek S (2004) Is stress urinary incontinence a familial condition? Acta Obstet Gynecol Scand 83:912–916PubMedCrossRef
4.
5.
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):715–721PubMedCrossRef
6.
Wing RR, Creasman JM, West DS et al (2010) Improving urinary incontinence in overweight and obese women through modest weight loss. Obstet Gynecol 116(2 Pt 1):284–292PubMedCentralPubMedCrossRef
7.
Subak LL, Whitcomb E, Shen H, Saxton J, Vittinghoff E, Brown JS (2005) Weight loss: a novel and effective treatment for urinary incontinence. J Urol 174:190–195PubMedCentralPubMedCrossRef
8.
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 110:1034–1040PubMedCrossRef
9.
Wing RR, West DS, Grady D et al (2010) Effect of weight loss on urinary incontinence in overweight and obese women: results at 12 and 18 months. J Urol 184:1005–1010PubMedCentralPubMedCrossRef
10.
11.
Bump RC, Sugerman HJ, Fantl JA, McClish DK (1992) Obesity and lower urinary tract function in women: effect of surgically induced weight loss. Am J Obstet Gynecol 167:392–397PubMedCrossRef
12.
Noblett KL, Jensen JK, Ostergard DR (1997) The relationship of body mass index to intra-abdominal pressure as measured by multichannel cystometry. Int Urogynecol J Pelvic Floor Dysfunct 8:323–326PubMedCrossRef
13.
Sugerman H, Windsor A, Bessos M, Kellum J, Reines H, DeMaria E (1998) Effects of surgically induced weight loss on urinary bladder pressure, sagittal abdominal diameter and obesity co-morbidity. Int J Obes Relat Metab Disord 22:230–235PubMedCrossRef
14.
Tok EC, Yasa O, Ertunc D, Savas A, Durukan H, Kanik A (2010) The effect of pelvic organ prolapse on sexual function in a general cohort of women. J Sex Med 7:3957–3962PubMedCrossRef
15.
Ryan DH, Espeland MA, Foster GD et al (2003) Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Control Clin Trials 24:610–628PubMedCrossRef
16.
Paffenbarger RS Jr, Wing AL, Hyde RT (1978) Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol 108:161–175PubMed
17.
Bump RC, Mattiasson A, Bø K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef
18.
Yarnell JW, Voyle GJ, Sweetnam PM, Milbank J, Richards CJ, Stephenson TP (1982) Factors associated with urinary incontinence in women. J Epidemiol Community Health 36:58–63PubMedCentralPubMedCrossRef
19.
Barber MD, Kuchibhatla MN, Pieper CF et al (2001) Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185:1388–1395PubMedCrossRef
20.
Toprak Celenay S, Akbayrak T, Kaya S, Ekici G, Beksac S (2012) Validity and reliability of the Turkish version of the Pelvic Floor Distress Inventory-20. Int Urogynecol J 23:1123–1127PubMedCrossRef
21.
22.
Hendrix SL, Clark A, Nygaard I et al (2002) Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol 186:1160–1166PubMedCrossRef
23.
24.
Schaffer JI, Wai CY, Boreham MK (2005) Etiology of pelvic organ prolapse. Clin Obstet Gynecol 48:639–647PubMedCrossRef
25.
Marchionni M, Bracco GL, Checcucci V et al (1999) True incidence of vaginal vault prolapse. Thirteen years of experience. J Reprod Med 44:679–684PubMed
26.
Bradley CS, Zimmerman MB, Qi Y, Nygaard IE (2007) Natural history of pelvic organ prolapse in postmenopausal women. Obstet Gynecol 109:848–854PubMedCrossRef
27.
Washington BB, Erekson EA, Kassis NC, Myers DL (2010) The association between obesity and stage II or greater prolapse. Am J Obstet Gynecol 202:503.e1–503.e4CrossRef
28.
Nygaard I, Bradley C, Brandt D, Women’s Health Initiative (2004) Pelvic organ prolapse in older women: prevalence and risk factors. Obstet Gynecol 104:489–497PubMedCrossRef
29.
30.
Richter HE, Burgio KL, Clements RH, Goode PS, Redden DT, Varner RE (2005) Urinary and anal incontinence in morbidly obese women considering weight loss surgery. Obstet Gynecol 106:1272–1277PubMedCrossRef
Metadata
Title
The improvement in pelvic floor symptoms with weight loss in obese women does not correlate with the changes in pelvic anatomy
Authors
Yavuz M. Gozukara
Gulcan Akalan
Ekrem C. Tok
Hakan Aytan
Devrim Ertunc
Publication date
01-09-2014
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 9/2014
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-014-2368-z

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