title: Bariatric surgery improves female pelvic floor disorders.
abstract: OBJECTIVE
  Obesity aggravates pelvic floor disorders in women. Weight loss improves these disorders. The purpose of this study was to assess the evolution of pelvic floor disorders in women who have undergone bariatric surgery.
  
  
  METHODS
  A prospective single-center study was conducted from December 2012 to February 2014. The parameters studied were diabetes, BMI, excess weight loss, multiparity, mode of delivery and their relation to obesity and pelvic floor disorders. We evaluated anorectal and urethral sphincter disorders using the PFDI-20 questionnaire preoperatively, at 1 month and then every 6 months thereafter.
  
  
  RESULTS
  One hundred and sixteen patients underwent bariatric surgery. Seventy questionnaires were completed preoperatively and postoperatively. Weight loss was significant with an excess weight loss of 57.1%. The mean body mass index (BMI) decreased from 44.5 ± 6.31 kg/m(2) (range: 35.0-63.23) to 31.83 ± 5.83 kg/m(2) (range: 20.9-49.6). The average length of follow-up was 11.3 ± 5.2 months (range: 5-25). The incidence of urinary symptoms improved after surgery (P=0.003), as did the UDI-6 score (Urogenital distress inventory) (P=0.009). There was no improvement in other symptoms such as prolapse and colorectal-anal dysfunction.
  
  
  CONCLUSIONS
  The prevalence of pelvic floor disorders is high among obese women; in this study, colorectal disorders were present in 53% and urinary disorders in 71.5%. Bariatric surgery-induced weight loss led to improvement in urinary continence disorders when assessed over an average follow-up of 11 months.
authors.affiliation: Service de chirurgie générale et digestive, CHU de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France. Electronic address: thomas.knepfler@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Knepfler
authors.affiliation: Service de chirurgie générale et digestive, CHU de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
authors.forename: E
authors.initials: E
authors.lastname: Valero
authors.affiliation: Service de chirurgie générale et digestive, CHU de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
authors.forename: E
authors.initials: E
authors.lastname: Triki
authors.affiliation: Service de chirurgie générale et digestive, CHU de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
authors.forename: N
authors.initials: N
authors.lastname: Chilintseva
authors.affiliation: Cabinet sage-femme, 53, rue des Capucins, 67200 Strasbourg, France.
authors.forename: S
authors.initials: S
authors.lastname: Koensgen
authors.affiliation: Service de chirurgie générale et digestive, CHU de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
authors.forename: S
authors.initials: S
authors.lastname: Rohr
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D015390:Gastric Bypass; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery*; D059952:Pelvic Floor Disorders / Q000150:complications* / Q000453:epidemiology; D011184:Postoperative Period; D015995:Prevalence; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Pelvic floor disorders; Urinary incontinence