Obesity and Pelvic Floor Disorders: A Review of the Literature

Abstract

Overweight and obesity are becoming a worldwide health problem associated with numerous co-morbidities. National costs of obesity and pelvic flor disorders have been rising since the 1950s across the world. Obesity is thought to have a very strong effect on pelvic floor disorders, and, considering the high prevalence of both problems worldwide, it is of utmost importance to evaluate the association between these pathologies as well as the impact of obesity on treatment efficacy. This review is based on a selection of reports in the literature (PubMed search), including guidelines and Cochrane reviews.Obesity seems to be a well-documented risk factor for lower urinary tract symptoms (LUTS) and is a predictor of exacerbation of stress urinary incontinence (SUI) and overactive bladder (OAB). Weight loss is also associated with improvement or resolution of SUI and OAB. In the case of pelvic organ prolapse (POP), weight loss is associated with improvement in quality of life. Although obesity is associated with POP in general, the exact role of obesity in symptomatic POP remains uncertain. While outcomes of anti-incontinence surgery among obese women are similar to those in non-obese women, postoperative urge incontinence is more likely to occur. It seems that obesity is not a risk factor for postoperative complications or short-term efficacy of POP surgical treatment. Long-term effects are still uncertain.Obesity is a strong risk factor for LUTS, but in most cases it does not affect efficacy of operative treatment. It may be associated with some post-operative complications. Weight loss in many cases allows avoiding surgical intervention.

Gait speed and overactive bladder in the healthy community‐dwelling super elderly: The Sukagawa Study

“…In this previous study, frailty was measured by TUGT and a slow TUGT exhibited a significant association with a diagnosis of OAB in patients who presented to an academic urology practice, although the authors did not investigate BMI, muscle mass, or strength. 10 Specifically for BMI, many previous studies have demonstrated the importance of overweight and obesity as risk factors of OAB, 11 and our results also support these findings. Several studies have further assessed the effectiveness of bariatric surgery on OAB and have shown postoperative improvement in symptoms among obese patients.…”

“…Furthermore, body weight, muscle mass, and strength were not investigated despite being major components for determining the state of physical frailty. Both overweight/obesity and underweight were reported to be associated with OAB . In addition, body muscle mass and strength might be associated with pelvic floor muscle strength and, therefore, with bladder function.…”

“…Both overweight/obesity and underweight were reported to be associated with OAB. 11,12 In addition, body muscle mass and strength might be associated with pelvic floor muscle strength and, therefore, with bladder function. Hence, we conducted a cross-sectional study to evaluate the association of physical frailty with OAB in older individuals by using a validated questionnaire for OAB and measuring body mass index (BMI), muscle mass, grip strength, and gait speed.…”

Upregulation of Foreign Body Response in Obese Mice

“…Obesity is considered a proinflammatory disease because of high accumulation of macrophages and their products within adipose tissue and other organs . In addition, this complex multifactorial metabolic problem is associated with many comorbidities, including diabetes, hypertension, heart failure, dyslipidemia, obstructive sleep apnea, weight‐related arthropathies, and urinary incontinence . Such complications very often require functional bioengineered substitutes such as artificial organs, scaffolds for tissue engineering, heart valves and other implantable devices like glucose sensors, orthopedic implants, catheters, drug‐eluting stents, or biosensors .…”

Alimentation, régimes et diététique dans le syndrome clinique d’hyperactivité vésicale : revue de la littérature

“…Un autre point important à prendre en considération est le poids ainsi que sa variation qui influent sur l'hyperactivité et les troubles urinaires (4,17,23). Pour cette raison, la majorité des études présentées étaient appariés sur le poids ou l'Indice de Masse Corporelle (IMC) et pris en compte dans l'analyse multivariée (4,(16)(17).…”