Obesity and Pelvic Floor Dysfunction: Battling the Bulge

Obstetrical & Gynecological Survey
Shireen de Sam LazaroAaron B Caughey

Abstract

Pelvic floor disorders (PFDs) comprise a broad spectrum of clinical conditions, including urinary incontinence, pelvic organ prolapse, fecal incontinence, and defecatory dysfunction. These disorders are common conditions that generate significant medical, emotional, social, and economic issues for many women. Obese women are disproportionately affected compared with their normal-weight peers, with more than half of women with a body mass index of greater than 35 kg/m(2) reporting a PFD, compared with only 32% in women with a normal body mass index. Despite this prevalence, little research is available to help guide and tailor treatment in obese populations. This review outlines current knowledge regarding the relative contribution of obesity to PFDs, as well as its effect on treatment implications. Literature relating to the incidence and treatment of PFDs in obese populations was reviewed. Both nonsurgical and surgical weight loss improves all PFDs. Obese women benefit from pelvic floor training, biofeedback, and pharmacologic treatments of urinary and fecal incontinence. Surgical treatments of stress urinary incontinence note increased operative times and perhaps slightly lower cure rates, but overall good treatment success i...Continue Reading

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