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Prolapse Symptoms in Overweight and Obese Women Before and After Weight Loss

Myers, Deborah L. MD*; Sung, Vivian W. MD, MPH*; Richter, Holly E. PhD, MD; Creasman, Jennifer MSPH; Subak, Leslee L. MDProgram to Reduce Incontinence by Diet and Exercise (PRIDE)

Female Pelvic Medicine & Reconstructive Surgery: January/February 2012 - Volume 18 - Issue 1 - p 55–59
doi: 10.1097/SPV.0b013e31824171f9
Original Articles

Objective The objective of this study was to estimate the association between body mass index (BMI) and pelvic organ prolapse symptoms and bother among overweight and obese women with urinary incontinence before and after weight loss.

Methods Women (N = 338) were randomized to either an intensive 6-month weight loss or educational program (control); they were evaluated for prolapse symptoms at baseline and 6 months. Symptomatic prolapse was defined as a positive response to at least 1 prolapse subscale question of the Urogenital Distress Inventory. “Bother” was defined as responses of slight, moderate, or great. Women with prolapse symptoms were analyzed by baseline BMI category: overweight, obese, and severely obese at baseline and at 6 months. Proportional odds regression and χ2 tests for trend were used for analysis.

Results Age mean was 53 (SD, 10) years, BMI mean was 36 (SD, 6) kg/m2, and 78% were white. A higher proportion of obese women reported feeling vaginal bulging compared with overweight women (13% vs 0%, P = <0.01). At baseline, 37% (n = 124) reported bothersome “lower abdominal pressure”; 18% (n = 62), bothersome “heaviness in the pelvic area”; and 14% (n = 48), bothersome “pelvic discomfort when standing.” Nine percent (n = 31) reported bothersome “feeling,” and 2% (n = 6) reported bothersome “seeing a bulge” in the vagina. At 6 months, there were no significant differences in improvement of self-reported bothersome prolapse symptoms in women in the weight loss or the control group.

Conclusions In this study of overweight and obese women, increasing BMI was associated with only “feeling” a vaginal bulge. Weight loss did not improve bothersome prolapse symptoms.

In this study of overweight and obese women, weight loss did not improve bothersome prolapse symptoms.

From the *Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI; †Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL; and ‡Department of Obstetrics and Gynecology, University of California at San Francisco, Women’s Health Clinical Research Center, San Francisco, CA.

Reprints: Deborah L. Myers, MD, 695 Eddy St, Providence, RI 02903. E-mail:

This study was funded through the U01DK067860, U01DK067861, U01DK067862, National Institutes of Diabetes and Digestive and Kidney Diseases (trial registration identifier NCT00091988).

The authors declare that they have nothing to disclose.

© 2012 by Wolters Kluwer Health | Lippincott Williams & Wilkins