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Impact of surgically induced weight loss on pelvic floor disorders

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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.

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Funding

American Urogynecologic Society Foundation Research Grant

Financial disclaimer/Conflict of interest

EL Whitcomb: AUGS Foundation Grant; MC Donohue: Bristol-Myers Squibb; S Horgan: Ethicon; ES Lukacz: Ethicon, Pfizer, Renew Medical

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Authors and Affiliations

  1. Southern California Permanente Medical Group, Irvine, CA, USA

    Emily L. Whitcomb

  2. University of California San Diego, San Diego, CA, USA

    Santiago Horgan, Michael C. Donohue & Emily S. Lukacz

  3. Female Pelvic Medicine and Reconstructive Surgery, Kaiser Permanente Irvine-Orange County Medical Center, 6650 Alton Parkway, Irvine, CA, 92618, USA

    Emily L. Whitcomb

Authors
  1. Emily L. Whitcomb
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  2. Santiago Horgan
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  3. Michael C. Donohue
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  4. Emily S. Lukacz
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Correspondence to Emily L. Whitcomb.

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Whitcomb, E.L., Horgan, S., Donohue, M.C. et al. Impact of surgically induced weight loss on pelvic floor disorders. Int Urogynecol J 23, 1111–1116 (2012). https://doi.org/10.1007/s00192-012-1756-5

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  • DOI: https://doi.org/10.1007/s00192-012-1756-5

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