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Effect of Surgically Induced Weight Loss on Pelvic Floor Disorders in Morbidly Obese Women

Wasserberg, Nir MD*; Petrone, Patrizio MD*; Haney, Mark MD*; Crookes, Peter F. MD; Kaufman, Howard S. MD, MBA*†

doi: 10.1097/SLA.0b013e31818c7082
Original Articles

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/m2 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/m2 (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.

To evaluate the effect of surgically induced weight loss on pelvic floor disorders, obese women considering bariatric surgery were asked to complete condition-specific questionnaires assessing pelvic floor dysfunction. Comparison between pre- and postoperative results revealed an improvement in quality of life and in symptoms related to urogenital and pelvic organ prolapse domains but less so in the colorectal domain.

From the *Division of Colorectal and Pelvic Floor Surgery and †Bariatric Surgery Program, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

Reprints: Nir Wasserberg, MD, Department of Surgery B, Rabin Medical Center, Beilinson Campus, Petah Tiqwa 49100, Israel. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.