Effects of bariatric surgery on pelvic floor function

Abstract

Background: Urinary incontinence is well documented as a comorbidity of obesity. Studies demonstrate improvement of incontinency after weight loss. However, the mechanisms are still not clear.

Aim: To analyze the effects of bariatric surgery on pelvic floor function in women.

Methods: Thirty women were invited to participate. They were waiting for bariatric surgery. Evaluations were done on pre-operative period and one year after surgery. It comprehended: body mass index, urinary incontinence prevalence, quality of life through the King's Health Questionnaire, quality of pelvic floor muscular contraction through the Oxford Modified Scale and perineometry.

Results: Twenty four women were included in the study. The body mass index reduced from 46.96±5.77 kg/m2 at the pre-operatory assessment to 29.97±3.48 kg/m2 one year after surgery. The average excess weight loss was 70.77±13.26%. The prevalence of urinary incontinence reduced from 70.8% to 20.8%. The King's Health Questionnaire showed significant reduction of urinary incontinence impact on quality of life in seven domains. The Oxford Modified Scale showed increased degree of muscular contraction after surgery. Perioneometry showed increased measure of muscular contraction after surgery. The average of the three ordered contractions went from 21.32±12.80 sauers to 28.83±16.17 sauers. The peak of contraction increased from 29±14.49 sauers to 30.92±16.20 sauers.

Conclusion: Massive weight loss due to bariatric surgery positively affects the function of the pelvic floor and quality of life on morbidly obese women.