title: Diabetes and obesity-related risks for pelvic reconstructive surgery in a cohort of Swedish twins.
abstract: OBJECTIVE
  To determine the diabetes- and obesity-related risks for surgically managed stress urinary incontinence and pelvic organ prolapse.
  
  
  METHODS
  This twin cohort study used the Swedish Twin Register to identify 8,443 female twin pairs born from 1926 through 1958. The association between diabetes and pelvic floor surgery was estimated while taking into account the correlated (twin) structure of the data.
  
  
  RESULTS
  For type 1 and type 2 diabetes, no significant associations were observed for stress urinary incontinence (odds ratio [OR] 1.0 [95% CI 0.1-9.2] and 2.0 [1.0-4.0], respectively). There were no cases of prolapse surgery in type 1 diabetic subjects, and for type 2 diabetes the risk estimate was nonsignificant (1.6 [1.0-2.7]). BMI >25 kg/m(2), age >or=60 years, and childbirth were the strongest risk factors for having incontinence surgery.
  
  
  CONCLUSIONS
  Our data suggest that diabetes is not associated with stress urinary incontinence or pelvic organ prolapse surgery.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Forsman
authors.forename: Anastasia
authors.initials: A
authors.lastname: Iliadou
authors.forename: Patrik
authors.initials: P
authors.lastname: Magnusson
authors.forename: Christian
authors.initials: C
authors.lastname: Falconer
authors.forename: Daniel
authors.initials: D
authors.lastname: Altman
mesh_terms: D015992:Body Mass Index; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000601:surgery; D010298:Parity; D011183:Postoperative Complications / Q000453:epidemiology*; D011247:Pregnancy; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D013548:Sweden; D014429:Twins, Dizygotic; D014430:Twins, Monozygotic; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery*; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*