Hypothesis / aims of study
In pelvic organ prolapse (POP), one or more of the intra-pelvic organs including the uterus, bladder, rectum and the urethra descend into the vaginal space, presumably due to deficiencies in the pelvic support system which normally provides sustained support . POP is a highly prevalent condition in women with prevalence rates ranging from 10% in younger women up to 50% in post-menopausal women . Nearly one in ten women will undergo surgical correction for POP in their lifetime . Aging and parity have been most consistently associated with POP ; however, these factors are not modifiable. Obesity is a modifiable risk factor which may be influenced on a population level to reduce the public health and economic burden of POP Effect estimates for POP in obese women (body mass index [BMI] ≥30 kg/m2 ) range from negative to a 2.5 fold increase in risk, when compared with women of normal weight.
The goals of this study is to provide overall effect estimates for POP with regard to degree of obesity, as measured by categories of body mass index.
Study design, materials and methods
Between 2022 and 2023, we retrospectively analyzed the body mass index of 75 women with Pelvic floor disorders
Results
The mean age was 56,5 years, 42% of the patients were postmenopausal, 35% were diabetic, 35% were multiparous, obesity were found in 75% of the cases, urinary incontinence was associated with nocturia in 50% of the cases, pollakiuria in 42% of cases and urgency in 23% of cases, At the perineal examination, a genital prolapse was found in all of the cases ; the first grade was found in 32% of cases, the second grade in 57% and the third grade in 11% , the testing of the levators ani was at 2 on average .The body mass index classifies 12% of women as having a normal BMI (18-25), 49% as overweight (25-30)and 39% as obese > 30.
Interpretation of results
Our study shows that suggests that obesity as measured by BMI is positively associated with overweight and obese women are more likely to have pelvic organ prolapse , The association between BMI and POP increases in magnitude with increasing categories of BMI and is larger for clinically-significant POP. Obesity is one of the few modifiable risk factors for POP
Concluding message
Pelvic organ prolapse are common conditions that disproportionately affect obese women. Although the literature surrounding the treatment of POP in obese women is limited, the available evidence demonstrates good treatment outcomes in obese populations. Further research is essential to improve counseling and treatment for these women, particularly as the obesity epidemic continues to rise. Future research should also focus on whether treatments are equally efficacious in obese women and varying strata of obese women. Ultimately, it appears that some of these disorders may improve in obese women who are able to lose weight, and this approach may benefit these pelvic floor symptoms. In addition, it could provide the incentive that such patients need to lose weight.