title: Impact of surgically induced weight loss on pelvic floor disorders.
abstract: OBJECTIVE
  Given the increased prevalence of obesity and pelvic floor disorders (PFDs), we estimated changes in prevalence, bother, and quality of life (QOL) for PFDs in obese women undergoing bariatric surgery. We hypothesized PFDs would improve after surgical weight loss.
  
  
  METHODS
  The prevalence, bother, and QOL impact of PFDs were estimated using validated measures. McNemar's and paired t tests were used to compare pre- and postprocedural outcomes. Power calculations deemed that 90 individuals would achieve at least 80 % power to detect a decrease in prevalence of 12 %.
  
  
  RESULTS
  The baseline mean (± standard deviation) age and body mass index (BMI) of the 98 women were 43.3 ± 11.8 years and 39.7 ± 6.2 kg/m.(2) BMI decreased to 34.4 ± 5.8 at 6 months and 34.0 ± 5.6 at 12 months. Whereas the overall prevalence of stress urinary incontinence (SUI) decreased from 22/69 (32 %) at baseline to 10/69 (15 %) at 6 months (p = 0.006) and 14/69 (20 %) at 12 months (p = 0.027), there were no significant decreases in overall prevalence of other PFDs. However, for women with SUI, overactive bladder (OAB), and anal incontinence at baseline, 11/23  (48 %), 8/11 (73 %) and 4/20 (20 %) resolved at 12 months, respectively. Pelvic Floor Impact Questionnaire scores decreased from baseline to 12 months (p < 0.001). Mean visual analog scores for women with SUI, OAB, and anal incontinence decreased at 12 months.
  
  
  CONCLUSIONS
  Surgical weight loss resulted in resolution of symptoms in nearly half of women with SUI and three quarters of women with OAB and was associated with significant improvement in QOL.
authors.affiliation: Southern California Permanente Medical Group, Irvine, CA, USA. Emily.L.Whitcomb@kp.org
authors.forename: Emily L
authors.initials: EL
authors.lastname: Whitcomb
authors.forename: Santiago
authors.initials: S
authors.lastname: Horgan
authors.forename: Michael C
authors.initials: MC
authors.lastname: Donohue
authors.forename: Emily S
authors.initials: ES
authors.lastname: Lukacz
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D015992:Body Mass Index; D015331:Cohort Studies; D003376:Counseling; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery*; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000453:epidemiology* / Q000209:etiology; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000209:etiology; D015431:Weight Loss