Thubert T, Deffieux X, Letouzey V, Hermieu J-F
Université Paris-Sud, 94276 Le Kremlin Bicêtre, France.
Prog Urol. 2012 Jul;22(8):445-53. doi: 10.1016/j.purol.2012.03.009. Epub 2012 May 30.
To determine the specificity of the management of urogynecologic disorders in obese women.
obesity, genital prolapse, pelvic organ prolapse, urinary incontinence, anal incontinence.
The relative risk of urinary incontinence (UI) for morbidly obese women (BMI>40 kg/m(2)) is five times greater than a normal weight woman. A 10% weight loss reduced the frequency of urinary leakage by 50%. Beyond a BMI of 35 kg/m(2), the success rate of suburethral sling decreased to 50% with an increased risk of de novo urgenturies. Within this population of morbidly obese women, bariatric surgery was as successful as or more than surgery for incontinence. Patients with morbid obesity are three times as likely to experience anal incontinence, with a prevalence reaching 32%. The treatment of anal incontinence in obese patients is not clearly codified. The association between obesity and prolapse is very controversial according to the methodology used in the studies. Treatment of genital prolapse in obese women is little studied in the literature. Only sacrocolpopexy by laparotomy was studied. No more complications were found in this population.
Now we have specific data concerning urogynecology in obese women to better manage these patients.
确定肥胖女性泌尿妇科疾病管理的特异性。
肥胖、生殖器脱垂、盆腔器官脱垂、尿失禁、肛门失禁。
病态肥胖女性（BMI>40 kg/m²）尿失禁（UI）的相对风险比正常体重女性高五倍。体重减轻10%可使漏尿频率降低50%。BMI超过35 kg/m²时，尿道下吊带手术成功率降至50%，新发尿急风险增加。在病态肥胖女性群体中，减肥手术治疗尿失禁的成功率与治疗尿失禁的手术相当或更高。病态肥胖患者发生肛门失禁的可能性是正常人的三倍，患病率达32%。肥胖患者肛门失禁的治疗尚无明确规范。根据研究所用方法，肥胖与脱垂之间的关联存在很大争议。文献中对肥胖女性生殖器脱垂治疗的研究较少。仅研究了经腹骶骨阴道固定术。该群体未发现更多并发症。
现在我们有了关于肥胖女性泌尿妇科的具体数据，以便更好地管理这些患者。
