General Surgery Unit, S'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Surg Obes Relat Dis. 2013 Jan-Feb;9(1):69-75. doi: 10.1016/j.soard.2011.08.013. Epub 2011 Aug 28.
Obesity, well known as a risk factor for several diseases, can also lead to pelvic floor dysfunction (PFD). However, scant data are available regarding PFD in obese individuals. Our study was designed to assess the prevalence, severity, and the quality of life (QOL) effect of PFD in obese women before and after bariatric surgery at a university hospital in Italy.
A total of 100 obese (body mass index [BMI] ≥30 kg/m(2)) women completed 6 validated specific and QOL questionnaires about PFD. The patients were evaluated by physical examination, endoanal ultrasonography, rectal balloon distension test, and dynamic magnetic resonance imaging. Of the 100 patients, 87 were reassessed 12 months after bariatric surgery.
The prevalence of PFD was 81%, and 49% of patients reported that their symptoms adversely affected their QOL. Urinary incontinence (UI) was the most common disorder (61%) and was associated with the BMI (P = .04). Fecal incontinence and pelvic organ prolapse symptoms were reported by 24 and 56 patients, respectively. Urogenital prolapse and rectocele was documented in 15% and 74% of patients, respectively. After a mean BMI reduction of 10 kg/m(2), the prevalence of PFD decreased to 48% (P = .02), with a significant improvement in QOL. The prevalence of UI decreased to 9.2% (P = .0001) and was associated with the decrease in postoperative BMI (P = .04). The rate of resolution of the symptoms was 84%, 85%, and 74% for UI, fecal incontinence, and pelvic organ prolapse, respectively.
In the present sample of obese women, PFD was common and adversely affected their QOL. A clear association was found between the BMI and UI. Weight loss resulted in improved UI, fecal incontinence, and symptoms of pelvic organ prolapse.
肥胖是多种疾病的危险因素，也可导致盆底功能障碍（PFD）。然而，关于肥胖人群中 PFD 的数据很少。我们的研究旨在评估意大利一家大学医院肥胖女性在接受减重手术后 PFD 的患病率、严重程度和生活质量（QOL）的影响。
共 100 名肥胖（BMI≥30kg/m²）女性完成了 6 项关于 PFD 的特定和 QOL 问卷。患者通过体格检查、腔内超声、直肠球囊扩张试验和动态磁共振成像进行评估。在 100 名患者中，87 名在减重手术后 12 个月时再次接受评估。
PFD 的患病率为 81%，49%的患者报告其症状对 QOL 产生不利影响。尿失禁（UI）是最常见的疾病（61%），与 BMI 相关（P=.04）。粪便失禁和盆腔器官脱垂症状分别报告了 24%和 56%的患者。泌尿生殖系统脱垂和直肠前突分别在 15%和 74%的患者中发现。BMI 平均降低 10kg/m²后，PFD 的患病率下降至 48%（P=.02），QOL 显著改善。UI 的患病率下降至 9.2%（P=.0001），与术后 BMI 降低相关（P=.04）。UI、粪便失禁和盆腔器官脱垂的症状缓解率分别为 84%、85%和 74%。
在本肥胖女性样本中，PFD 很常见，且对 QOL 产生不利影响。BMI 与 UI 之间存在明显关联。体重减轻导致 UI、粪便失禁和盆腔器官脱垂症状得到改善。
