Abstract: PD50-03
Sources of Funding: None

Introduction

Data regarding the effects of overweight on various aspects of pelvic floor function, as well as the potential reversibility of pelvic floor disorders following significant weight loss, are scarce. The aim of this prospective study was to assess the effect of surgically-induced weight loss on female urinary incontinence (UI), pelvic organ prolapse (POP), colorectal-anal complaints and sexual dysfunction.

Methods

160 consecutive women (age>18 years), who underwent bariatric surgery in a single university-affiliated medical center, were prospectively enrolled. Four validated questionnaires (ICIQ-UI, BFLUTS-SF, PFDI-20, PISQ-12) were used to evaluate pelvic floor disorders and sexual dysfunction before, and 3-6 months after surgery.The study protocol was approved by the local hospital Helsinki committee.

Results

150 women (mean age 43±12.8) completed all pre- and postoperative questionnaires. Mean BMIs before, and 3-6 months after surgery were 42±4.6 and 32±4.6 kg/m2, respectively. Preoperatively, 56 (37.3%) women had UI, 44 (29.3%) women had POP symptoms, and 66 (44%) women had colorectal-anal symptoms. Pre and postoperative results of the 56 preoperatively incontinent women are presented in Table. Postoperative weight loss was associated with statistically significant improvement in UI (mean ICIQ score 9.3±3.9 vs 3.3±3.8, P<0.001). Incontinence was either improved or entirely resolved in 30/33 (91%) women with stress UI, 15/17 (88%) women with mixed UI, 3/4 (75%) women with urgency UI. Overall, weight loss was also associated with statistically significant improvement in POP symptoms (mean PFDI score 19±13.2 vs 11±12.8, P<0.001), and colorectal-anal symptoms (mean PFDI score 21±15.9 vs 14±14.9, P=0.004). Moreover, half of preoperatively incontinent women, and more than 25% of women who had either POP, or colorectal-anal symptoms, reported complete resolution of their symptoms. Statistically significant improvement in sexual function was suggested by both BFLUTS-SF (0.3±0.8 to 0.1±0.6; P=0.011) and PISQ-12 (37.9±6.1 to 39.5±5; P=0.003) questionnaires.

Conclusions

Surgically-induced weight loss was associated with a significant improvement in pelvic floor disorders, including all major types of UI, POP and colorectal-anal symptoms; as well as improved sexual performance.

Funding

None