Effect of surgically induced weight loss on pelvic floor disorders in morbidly obese women

Objective: To evaluate the effect of surgically induced weight loss on pelvic floor disorders (PFD) in morbidly obese women. Summary Background Data: Although bariatric surgery may lead to the improvement of some obesity-related comorbidities, the resolution of global PFD has not been well described. Methods: Women with a body mass index (BMI) of 35 kg/m or more who were considering bariatric surgery were asked to complete 2 validated condition-specific questionnaires assessing the distress/quality of life impact of PFD, total and by domain (pelvic organ prolapse, colorectal-anal, and urogenital). Women who achieved a ≥50% excess body weight loss after surgery were asked to complete the same questionnaires for comparison. Results: Of the 178 women who underwent surgery, 46 completed the postoperative questionnaires. Mean age of this group was 45 years (range, 20-67), and mean preoperative BMI was 45 kg/m (range, 35-75). The prevalence of PFD symptoms improved from 87% before surgery to 65% after surgery (P = 0.02, 95% CI: 0.05%-53%). There was a significant reduction in total mean distress scores after surgery (P = 0.015, 95% CI: 3.3-32.9), which was attributed mainly to the significant decrease in urinary symptoms (P = 0.0002, 95% CI: 8.2-22.7). Reductions in the scores were noted for the other PFD domains as well. Quality of life total scores improved (P = 0.002, 95% CI: 4.8-27.1), as did scores in the urinary domain (P = 0.0005, 95% CI: 3.8-13.5) and the pelvic organ prolapse domain (P = 0.015, 95% CI: 0.6-9.5). Age, parity, history of complicated delivery, percent excess body weight loss, BMI, type of weight loss procedure and presence of diabetes mellitus and hypertension had no predictive value for postoperative outcomes. Conclusion: Surgically induced weight loss has a beneficial effect on symptoms of PFD in morbidly obese women.