Pelvic Organ Prolapse and Urinary Incontinence in Women After Bariatric Surgery: 5-Year Follow-up
- 1 March 2018
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Urogynecology
- Vol. 24 (2), 120-125
- https://doi.org/10.1097/spv.0000000000000505
Abstract
Objective The objective of this study was to determine if weight loss surgery is associated with decreased prevalence of urinary incontinence (UI) and pelvic organ prolapse (POP) symptoms. Methods A survey was conducted among previously morbidly obese women who underwent bariatric surgery at Brigham and Women's Hospital, Boston from 2007 to 2015. In addition to the Pelvic Floor Distress Inventory 20, we collected demographic and clinical data including symptoms of and treatment for UI and POP before surgery. Participants were divided into 4 quartiles based on self-reported postsurgical weight loss: less than 26.1 kg, 26.1 to 36.2 kg, 36.3 to 46.2 kg, and greater than 46.2 kg. Cox proportional hazard ratios were used to estimate risk of UI and POP by quartile. Kruskal-Wallis test was used to compare bother scores between the groups. Results A total of 447 women responded to the survey. Mean follow-up from surgery was 5 years. Women with Roux-en-Y gastric bypass had significantly greater weight loss than gastric banding or sleeve gastrectomy. The adjusted hazard ratios of current UI, stress UI, urgency UI, and prolapse decreased with increasing weight loss quartile (P trend <0.005). Based on the Pelvic Floor Distress Inventory 20, prevalence of POP symptoms was 26% with a mean bother score of 50. Although symptom bother by quartile of weight loss was not statistically significant, the trend (from the first to fourth quartile) for the mean values of Urogenital Distress Inventory 6 (from 13 to 9) and Pelvic Organ Prolapse Distress Inventory 6 (from 26 to 20) showed an improvement in bother symptoms. Conclusions There exists an inverse relationship between amount of weight loss and subsequent POP and UI symptoms 5 years after bariatric surgery.Keywords
This publication has 25 references indexed in Scilit:
- Clinical and instrumental evaluation of pelvic floor disorders before and after bariatric surgery in obese womenSurgery for Obesity and Related Diseases, 2013
- Long-term quality of life and pelvic floor dysfunction after bariatric surgeryAmerican Journal of Obstetrics and Gynecology, 2012
- Keeping the Balance as We Move ForwardUrogynecology, 2012
- Obesity is associated with increased prevalence and severity of pelvic floor disorders in women considering bariatric surgerySurgery for Obesity and Related Diseases, 2009
- Weight Loss to Treat Urinary Incontinence in Overweight and Obese WomenThe New England Journal of Medicine, 2009
- Will All Americans Become Overweight or Obese? Estimating the Progression and Cost of the US Obesity EpidemicObesity, 2008
- Prevalence of Symptomatic Pelvic Floor Disorders in US WomenJAMA, 2008
- Global burden of obesity in 2005 and projections to 2030International Journal of Obesity, 2008
- Changes in Urinary and Fecal Incontinence Symptoms With Weight Loss Surgery in Morbidly Obese WomenObstetrics & Gynecology, 2007
- Pelvic Organ Prolapse in Older Women: Prevalence and Risk FactorsObstetrics & Gynecology, 2004