Are Obese Patients at an Increased Risk of Pelvic Floor Dysfunction Compared to Non-obese Patients?

Neto, Iran Eduardo Lima; Pinto, Rodrigo Ambar; Jorge, José Márcio Neves; Santo, Marco Aurélio; Bustamante-Lopez, Leonardo Alfonso; Cecconello, Ivan; Nahas, Sérgio Carlos

doi:10.1007/s11695-017-2559-z

Cited by 20 publications

(10 citation statements)

References 37 publications

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“…In both contractions, the mean muscle strength of obese women was lower with non-obese women in both pretreatment and in the acute and chronic phase after treatment. Similar findings were found by Corrêa Neto et al [26], who compared 26 obese women to non-obese women, and showed that the pressure strength of pelvic floor muscles evaluated by manometry was lower in obese women. In addition to lower muscle strength, 65.4% of the obese women had symptoms of fecal incontinence.…”

Section: Plos Onesupporting

confidence: 87%

Chemoradiation for cervical cancer treatment portends high risk of pelvic floor dysfunction

et al. 2020

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To assess the impact of chemoradiation on pelvic floor (PF) muscle function after the treatment of cervical cancer (CC). Methods We performed a prospective cohort study of women between the ages of 20 and 70 years old who had a diagnosis of CC. Patients were treated with chemoradiation at the Barretos Cancer Hospital (BCH), between August 2016 and July 2017. We performed three evaluations at different time points after chemoradiation treatment to compare changes in muscle function. Pelvic floor muscle function was assessed through perineometry (PNM) and surface electromyography (EMG) at the following time points: Pretreatment Moment 1 (M1): evaluated before chemoradiation; Moment 2 (M2): at the first follow-up medical visit (usually 3 to 4 months after treatment); and Moment 3 (M3): at the second follow-up medical visit (usually after 6 to 9 months after treatment). Mean vaginal squeeze pressure levels were determined by PNM and muscle electromyographic activity by EMG and the results were evaluated by Generalized Linear Model comparisons. Results Forty-nine patients were evaluated at M1; 35 at M2; and 32 at M3, so that 32 patients had all three muscle evaluations performed. There was a statistically significant increase in the frequency of women with urgency urinary incontinence at the M2 evaluation time (41.9%), compared to pretreatment M1 (18.6%), p<0.001. The means of the vaginal squeeze pressures reduced through M1 to M3 in the phasic (M1: 17.7 mmHg; M3: 11.27mmHg) and tonic contractions (M1: 10.56 mmHg; M3: 7.52mmHg), p = 0.01 and p = 0.03 respectively. There

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Section: Plos Onesupporting

confidence: 87%

Chemoradiation for cervical cancer treatment portends high risk of pelvic floor dysfunction

et al. 2020

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“…-----symptom scores between groups, no significant differences were observed with p=0. 16 and p=0.14, respectively.…”

Section: ---mentioning

confidence: 87%

“…There is much evidence in the literature associating overweight and PFMD [12][13][14]; however, most studies have been conducted in middle-aged or elderly women [15][16][17], offering little information on young adult women. Knowledge about the influence of overweight/obesity on PFMD symptoms in adult women may help in the prevention of PFMD that will reflect on the reduction of symptoms in older age, as well as on the clarification of those comorbidities in this population, since overweight.…”

Section: Introductionmentioning

confidence: 99%

Pelvic, anorectal and urinary symptoms according to the nutritional status of adult women: A cross-sectional study

et al. 2019

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To review the occurrence of pelvic, anorectal and urinary symptoms according to the nutritional status of adultwomen. Methods This is a cross-sectional study with 54 women, aged 18 to 35 years, divided into normal weight (<25kg/m2), overweight (25kg/m2 to 29.99kg/m2) and obesity (≥30kg/m2) according to the body mass index. The presence of pelvic floor muscle dysfunction symptoms was assessed by the Pelvic Floor Distress Inventory and the impact of these symptoms by the Pelvic Floor Impact Questionnaire. Descriptive and inferential statistics were used, with a significance level of 5%. Results Pelvic Floor Distress Inventory total score was 22.95 (SD=26.11) in the eutrophic group and 59.67 (SD=47.80) in the obesity group (p=0.01). Considering the scales, urinary symptoms were higher in obese women than in the eutrophic group (p=0.01). In the assessment of patients with each symptom, a difference (p<0.01) was observed in incomplete bowel emptying, in which the highest frequency occurred in overweight women (47.4%) compared to eutrophic and obese women (both 26.3%). Urinary incontinence symptoms (18.2% in eutrophic women, 27.3% overweight and 54.5% obese), stress urinary incontinence (8.3% eutrophic, 41.7% overweight and 50.0%, obese) and difficulty in emptying the bladder (0.0% eutrophic, 33.3% overweight and 66.7% obese) exhibited higher frequencies (p=0.03; p<0,01 and p=0.02, respectively) in obese women. Conclusion Symptoms of pelvic floor muscles dysfunction, especially urinary tract muscles, occur more frequently in obese adult women when compared to eutrophic women.

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“…Likewise, in the present study, mean total contraction pressures (231.27 vs. 145.63 mmHg, p=0.002) and isolated external anal sphincter pressures (153.89 vs. 79.78, p=0.007) were significantly higher in men when compared to women. Among other factors, the greater density of muscle mass and contractile force in male individuals could justify the higher contraction pressures 5 .…”

Section: Discussionmentioning

confidence: 99%

Anorectal Manometry Standard of a Brazilian Population at Productive Age Without Pelvic Floor Disorders: A Prospective Volunteered Study

Pinto

Neto

Bustamante-Lopez

et al. 2021

ABCD, arq. bras. cir. dig.

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Background: Due to the lack of normal standards of anorectal manometry in Brazil, data used are subject to normality patterns described at different nationalities. Aim: To determine the values and range of the parameters evaluated at anorectal manometry in people, at productive age, without pelvic floor disorders comparing the parameters obtained between male and female. Methods: Prospective analysis of clinical data, such as gender, age, race, body mass index (BMI) and anorectal manometry, of volunteers from a Brazilian university reference in pelvic floor disorders. Results: Forty patients were included, with a mean age of 45.5 years in males and 37.2 females (p=0.43). According to male and female, respectively in mmHg, resting pressures were similar (78.28 vs. 63.51, p=0.40); squeeze pressures (153.89 vs. 79.78, p=0.007) and total squeeze pressures (231.27 vs. 145.63, p=0.002). Men presented significantly higher values of anorectal squeeze pressures, as well as the average length of the functional anal canal (2.85 cm in male vs. 2.45 cm in female, p=0.003). Conclusions: Normal sphincter pressure levels in Brazilians differ from those used until now as normal literature standards. Male gender has higher external anal sphincter tonus as compared to female, in addition a greater extension of the functional anal canal

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Are Obese Patients at an Increased Risk of Pelvic Floor Dysfunction Compared to Non-obese Patients?

Abstract: The prevalence of fecal incontinence among obese patients was high regardless of age, gender, and body mass index. Anal squeeze pressure was significantly lower in obese patients compared to non-obese controls.

Cited by 20 publications

References 37 publications

Chemoradiation for cervical cancer treatment portends high risk of pelvic floor dysfunction

Chemoradiation for cervical cancer treatment portends high risk of pelvic floor dysfunction

Pelvic, anorectal and urinary symptoms according to the nutritional status of adult women: A cross-sectional study

Anorectal Manometry Standard of a Brazilian Population at Productive Age Without Pelvic Floor Disorders: A Prospective Volunteered Study

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