Best Practice & Research Clinical Obstetrics & Gynaecology
9Obesity and pelvic floor dysfunction
Section snippets
Obesity and pelvic floor disorders
Obesity is a modern epidemic. The worldwide prevalence of obesity has doubled from 1980 to 2008. The current prevalence of obesity is 14% among women and 10% in men [1]. Obesity presents not only with well-described major medical conditions but also a number of quality-of-life issues. Pelvic floor dysfunction is more common in the overweight and obese group of patients. Obesity may impair pelvic floor function due to many reasons. These include a chronic increase in intra-abdominal pressure,
Obesity and pelvic organ prolapse
Myers' study on prolapse symptoms in obese and overweight women showed that 37% of patients admitted to prolapse symptoms in the obese group [28]. Intensive non-surgical weight loss did not lead to any improvement in prolapse symptoms in this study. Machin's review on aetiological factors in pelvic organ prolapse also indicates a consistent association of obesity with pelvic organ prolapse [29]. Hendrix described that all the different types of prolapse were associated with obesity. Morbid
Obesity and defaecatory disorders
Defaecatory disorders, particularly faecal incontinence, are distressing symptoms that impair social mobility in an individual. Sileri observed that 59% of patients undergoing bariatric surgery reported defaecatory disorder symptoms before undergoing surgery. This was a range of constipation, faecal incontinence or a combination of the two. Sileri also observed that, after bariatric surgery, there was an improvement in both the constipation and faecal incontinence severity scores with
Obesity and sexual dysfunction
Sexual function is affected by several factors including body image, body confidence, low mood, depressive symptoms, coexistent pelvic floor dysfunction such as urinary incontinence, prolapse or faecal incontinence that may cause embarrassment during sexual intercourse.
Sexual dysfunction is difficult to report due to under-reporting of the nature of symptoms. Sexual dysfunction has been reported to be as high as 51% in women presenting for bariatric surgery and 41% in women presenting for
Conclusion
Obesity is well known to be associated with medical disorders. More recently, the associations between obesity and quality-of-life issues have also been widely researched. The relationship between pelvic floor function and obesity has been described thoroughly in recent studies. The associations between urinary function, bowel function, sexual function and prolapse have been described in various studies. Weight loss by surgical and other non-surgical methods seems to help with the improvement
Conflict of interest
None.
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Cited by (72)
Pelvic floor dysfunction and obesity
2023, Best Practice and Research: Clinical Obstetrics and GynaecologyPelvic Organ Prolapse
2022, Physician Assistant ClinicsCitation Excerpt :The patient can be counseled on lifestyle modifications, which may include weight loss. Strikingly, a 5% reduction in weight loss can lead to a 50% reduction in pelvic floor dysfunction including urinary incontinence, but the same results have not been shown in improving POP symptoms or reversing herniation.24 However, one could propose that it could stop the progression and worsening of POP.
Association between obesity and female sexual dysfunction: a review
2024, Sexual Medicine Reviews