Leshem Avner, Shimonov Mordechai, Amir Hadar, Gordon David, Groutz Asnat
Lis Maternity and Women's Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
E. Wolfson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Urology. 2017 Jul;105:42-47. doi: 10.1016/j.urology.2017.03.003. Epub 2017 Mar 16.
To assess the effect of weight loss on urinary incontinence (UI), pelvic organ prolapse, colorectal-anal complaints, and sexual dysfunction among obese women undergoing bariatric surgery.
One hundred sixty consecutive women who underwent bariatric surgery were prospectively enrolled. Four validated questionnaires (International Consultation on Incontinence Questionnaire-UI [ICIQ-UI], Bristol Female Lower Urinary Tract Symptoms-SF [BFLUTS-SF], Pelvic Floor Distress Inventory-20 [PFDI-20], and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 [PISQ-12]) were used to evaluate pelvic floor disorders and sexual dysfunction before and 3-6 months after surgery.
One hundred fifty participants (mean age: 43 ± 12.8 years; mean preoperative body mass index: 42 ± 4.6 kg/m) completed all pre- and postoperative questionnaires. Preoperatively, 56 (37.3%) women had UI, 44 (29.3%) women had pelvic organ prolapse symptoms, and 66 (44%) women had colorectal-anal symptoms. Overall, surgically induced weight loss was associated with statistically significant improvement in UI (mean ICIQ score: 9.3 ± 3.9 vs 3.3 ± 3.8, P <.001), pelvic organ prolapse symptoms (mean PFDI score: 19 ± 13.2 vs 11 ± 12.8, P <.001), and colorectal-anal symptoms (mean PFDI score: 21 ± 15.9 vs 14 ± 14.9, P = .004). Moreover, half of preoperatively incontinent women and more than one quarter of women who had either pelvic organ prolapse or colorectal-anal symptoms reported complete resolution of their symptoms. Statistically significant improvement in sexual function was suggested by both BFLUTS-SF (0.3 ± 0.8 vs 0.1 ± 0.6; P = .011) and PISQ-12 (37.9 ± 6.1 vs 39.5 ± 5; P = .003) questionnaires.
Surgically induced weight loss was associated with a significant improvement in pelvic floor disorders, including UI, pelvic organ prolapse, and colorectal-anal symptoms, as well as improved sexual performance.
评估减肥对接受减肥手术的肥胖女性尿失禁（UI）、盆腔器官脱垂、结直肠肛门疾病及性功能障碍的影响。
前瞻性纳入160例连续接受减肥手术的女性。使用4份经过验证的问卷（国际尿失禁咨询问卷-UI[ICIQ-UI]、布里斯托尔女性下尿路症状简表[BFLUTS-SF]、盆底困扰量表-20[PFDI-20]和盆腔器官脱垂/尿失禁性功能问卷-12[PISQ-12]）评估手术前及术后3 - 6个月的盆底疾病和性功能障碍。
150名参与者（平均年龄：43±12.8岁；术前平均体重指数：42±4.6kg/m²）完成了所有术前和术后问卷。术前，56名（37.3%）女性有尿失禁，44名（29.3%）女性有盆腔器官脱垂症状，66名（44%）女性有结直肠肛门症状。总体而言，手术引起的体重减轻与尿失禁（平均ICIQ评分：9.3±3.9 vs 3.3±3.8，P＜0.001）、盆腔器官脱垂症状（平均PFDI评分：19±13.2 vs 11±12.8，P＜0.001）和结直肠肛门症状（平均PFDI评分：21±15.9 vs 14±14.9，P = 0.004）的统计学显著改善相关。此外，术前尿失禁的女性中有一半以及有盆腔器官脱垂或结直肠肛门症状的女性中有超过四分之一报告症状完全缓解。BFLUTS-SF问卷（0.3±0.8 vs 0.1±0.6；P = 0.011）和PISQ-12问卷（37.9±6.1 vs 39.5±5；P = 0.003）均表明性功能有统计学显著改善。
手术引起的体重减轻与盆底疾病的显著改善相关，包括尿失禁、盆腔器官脱垂和结直肠肛门症状，以及性功能的改善。
