The effect of women’s body mass index on pelvic organ prolapse: a systematic review and meta analysis

Abstract

Background Pelvic organ prolapse remains the public health challenge globally. Existing evidences report the effect of woman’s weight on the pelvic organ prolapse inconsistently and this urges the need of pooled body weight effect on the pelvic organ prolapse. Although there was a previous work on this regard, it included papers reported before June 18/2015. Thus, updated and comprehensive evidence in this aspect is essential to devise strategies for interventions. Objective This review aimed at synthesizing evidence regarding the pooled effect of body weight on the pelvic organ prolapsed. Methods For this review, we searched all available articles through databases including PubMed, Web of Sciences, CINAHL, JBI library, Cochran library, PsycInfo and EMBASE as well as grey literature including Mednar, worldwide science, PschEXTRA and Google scholar. We included cohort, case–control, cross-sectional and experimental studies which had been reported between March 30, 2005 to March 30, 2020. In the effect analysis, we utilized random model. The heterogeneity of the studies was determined by I2 statistic and the publication bias was checked by Egger’s regression test. Searching was limited to studies reported in the English language. Results A total of 14 articles with 53,797 study participants were included in this systematic review (SR) and meta analysis (MA). The pooled result of this Meta analyses depict that body mass index (BMI) doesn’t have statistical significant association with pelvic organ prolapse. Conclusion This review point out that women’s body mass index has no significant effect on the development of pelvic organ prolapse. However, the readers should interpret the result with cautions due to the presence of considerable limitations in this work. Trial registration The protocol of this systematic review (SR) and meta analysis (MA) has been registered in PROSPERO databases with the Registration number of CRD42020186951

Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis

“…For primary POP, 2 studies reported BMI as a risk factor. 50,51 On the contrary, the systematic review by Zenebe et al 52 found no association between BMI and primary POP. This difference might be because of broader inclusion criteria for the definition of POP.…”

“…Subjective outcome measures may be confounded by spectrum bias. 52 In fact, approximately 8% of women report bothersome bulge symptoms without having an anatomic or objective prolapse. 59,60 It would be interesting to see whether the risk factors for subjective prolapse are applicable for anatomic prolapse also.…”

How do reproductive history and anthropometry in midlife relate to later risk of pelvic organ prolapse? A prospective cohort study

“…While some found maternal history of POP to be a strong risk factor [4,11,12] others found advancing age, parity and body-mass index (BMI) to be most consistently associated with POP [13,14]. However, recent research disputes the association between increasing BMI and POP [15]. Other reported predictors are hysterectomy, levator ani muscle injury and urinary incontinence before and during pregnancy [12,16,17].…”

Long-Term Assessment of Pelvic Organ Prolapse Reoperation Risk in Obese Women: Vaginal and Laparoscopic Approaches

“…In the literature, the highest risk factors for the development of POP are age, parity, and vaginal delivery [19]. The association between obesity and POP seems to be more controversial [6]. Giri et al published a meta-analysis suggesting an association between obesity and POP.…”

“…Obesity is a well-known risk factor for stress urinary incontinence (SUI) [4]. However, its role in pelvic organ prolapse (POP) remains controversial [5,6]. It is not a contraindication to prolapse surgery, whatever the surgical procedure [7,8].…”