The improvement in pelvic floor symptoms with weight loss in obese women does not correlate with the changes in pelvic anatomy

Introduction and hypothesis It has been suggested that weight reduction decreases the frequency of urinary incontinence (UI) episodes. However, it is not known if this improvement is associated with anatomical changes in the pelvis. The aim of this study was to investigate the effects of weight loss...

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Bibliographic Details
Published in:	International Urogynecology Journal Vol. 25; no. 9; pp. 1219 - 1225
Main Authors:	Gozukara, Yavuz M., Akalan, Gulcan, Tok, Ekrem C., Aytan, Hakan, Ertunc, Devrim
Format:	Journal Article
Language:	English
Published:	London Springer London 01-09-2014 Springer Nature B.V
Subjects:	Adult Cohort Studies Female Gynecology Humans Medicine Medicine & Public Health Middle Aged Obesity - complications Original Article Pelvic Floor - pathology Urinary Incontinence - etiology Urinary Incontinence - pathology Urinary Incontinence - therapy Urology Weight Loss Urinary incontinence Weight reduction Pelvic Organ Prolapse Quantification system
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Summary:	Introduction and hypothesis It has been suggested that weight reduction decreases the frequency of urinary incontinence (UI) episodes. However, it is not known if this improvement is associated with anatomical changes in the pelvis. The aim of this study was to investigate the effects of weight loss on UI episodes and pelvic floor anatomy. Methods Three hundred seventy-eight overweight/obese women were randomly allocated either to behavioral weight loss or to structured education programs. The patients were evaluated by voiding diary, Pelvic Floor Distress Inventory (PFDI), and Pelvic Organ Prolapse Quantification (POP-Q) system at baseline and after 6 months. Results The women in the intervention group had a mean weight loss of 9.4 %, whereas the weight in the control group remained almost the same ( P < 0.001). While there were no change in stress and urge incontinence episodes in the control group, the mean number of stress incontinence episodes per 3-day diary dropped from 7.96 episodes to 3.11, and the mean number of urge incontinence episodes per 3-day diary dropped from 2.85 episodes to 1.08 in the study group ( P < 0.05). Regarding the POP-Q system, only genital hiatus, perineal body, and Ap measurements were significantly lower in the weight loss group than in the control group after 6 months. Conclusions Weight reduction provides improvement in episodes of UI, decreases the incidence of drops of urine leakage, and increases quality of life related to pelvic floor symptoms. However, there are little to no changes in the parameters of the POP-Q system with weight reduction.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0937-3462 1433-3023
DOI:	10.1007/s00192-014-2368-z