Wasserberg Nir, Haney Mark, Petrone Patrizio, Ritter Manfred, Emami Claudia, Rosca Jason, Siegmund Kim, Kaufman Howard S
Department of Surgery, Division of Colorectal and Pelvic Floor Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Dis Colon Rectum. 2007 Dec;50(12):2096-103. doi: 10.1007/s10350-007-9058-6. Epub 2007 Sep 27.
This study was designed to determine the impact of excess body mass on the prevalence of pelvic floor disorders in morbidly obese females.
A total of 358 morbidly obese females (body mass index (BMI) >or= 35 kg/m(2)) completed two validated, condition-specific, quality of life questionnaires of pelvic floor dysfunction, which assessed stress/impact in three main domains of pelvic floor disorders: pelvic organ prolapse, colorectal-anal, and urogenital incontinence. Prevalence and severity scores in the study population were compared with data from 37 age-matched nonobese controls (BMI <or= 35 kg/m(2)).
Mean age was 43 +/- 11 years vs. 42 +/- 12 years, and mean BMI was 50 +/- 10 kg/m(2) vs. 26 +/- 4 kg/m(2) (p = 0.02) in the study and control groups, respectively. Parity and past obstetric history were similar between the groups. Pelvic floor disorders were prevalent in 91 percent of the morbidly obese females compared with 22 percent in the control group (p < 0.001). Scores were statistically significantly higher in the study group for all studied stress/impact domains (p < 0.001 and p = 0.001, respectively). Further stratifications in the study group revealed a significant impact on pelvic floor disorders with increased age (p < 0.003 and p < 0.009 for stress/impact mean scores, respectively) and the presence of other comorbidities (p< 0.008, p < 0.03 for stress/impact prevalence, respectively). Additional increases in BMI > 35 kg/m(2) did not show increased adverse impacts on pelvic floor disorders symptoms.
More than 90 percent of morbidly obese females experience some degree of pelvic floor disorders, and 50 percent of these females report that symptoms adversely impact quality of life. In morbidly obese females, obesity is as important as obstetric history in predicting pelvic floor dysfunction.
本研究旨在确定超重对病态肥胖女性盆底功能障碍患病率的影响。
共有358名病态肥胖女性（体重指数（BMI）≥35kg/m²）完成了两份经过验证的、针对特定病情的盆底功能障碍生活质量问卷，这些问卷评估了盆底功能障碍三个主要领域的压力/影响：盆腔器官脱垂、结直肠-肛门和泌尿生殖系统失禁。将研究人群中的患病率和严重程度评分与37名年龄匹配的非肥胖对照者（BMI≤35kg/m²）的数据进行比较。
研究组和对照组的平均年龄分别为43±11岁和42±12岁，平均BMI分别为50±10kg/m²和26±4kg/m²（p = 0.02）。两组之间的产次和既往产科病史相似。91%的病态肥胖女性存在盆底功能障碍，而对照组为22%（p < 0.001）。在所有研究的压力/影响领域，研究组的评分在统计学上显著更高（分别为p < 0.001和p = 0.001）。研究组的进一步分层显示，年龄增加（压力/影响平均评分分别为p < 0.003和p < 0.009）和存在其他合并症（压力/影响患病率分别为p < 0.008、p < 0.03）对盆底功能障碍有显著影响。BMI>35kg/m²的进一步增加并未显示对盆底功能障碍症状有增加的不利影响。
超过90%的病态肥胖女性经历某种程度的盆底功能障碍，其中50%的女性报告症状对生活质量有不利影响。在病态肥胖女性中，肥胖在预测盆底功能障碍方面与产科病史同样重要。
