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Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?

INTRODUCTION: Obesity is one of the well-documented risk factors of pelvic floor disorders (PFDs). The PFDs include urinary and fecal incontinence (UI, FI) and pelvic organ prolapse (POP). Surgery-induced weight loss improves different kinds of incontinence as well as POP symptoms. However, there is...

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Autores principales: Pomian, Andrzej, Majkusiak, Wojciech, Lisik, Wojciech, Tomasik, Paweł, Horosz, Edyta, Zwierzchowska, Aneta, Kociszewski, Jacek, Barcz, Ewa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973994/
https://www.ncbi.nlm.nih.gov/pubmed/29256106
http://dx.doi.org/10.1007/s11695-017-3067-x
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author Pomian, Andrzej
Majkusiak, Wojciech
Lisik, Wojciech
Tomasik, Paweł
Horosz, Edyta
Zwierzchowska, Aneta
Kociszewski, Jacek
Barcz, Ewa
author_facet Pomian, Andrzej
Majkusiak, Wojciech
Lisik, Wojciech
Tomasik, Paweł
Horosz, Edyta
Zwierzchowska, Aneta
Kociszewski, Jacek
Barcz, Ewa
author_sort Pomian, Andrzej
collection PubMed
description INTRODUCTION: Obesity is one of the well-documented risk factors of pelvic floor disorders (PFDs). The PFDs include urinary and fecal incontinence (UI, FI) and pelvic organ prolapse (POP). Surgery-induced weight loss improves different kinds of incontinence as well as POP symptoms. However, there is a lack of evidence how bariatric surgery influences pelvic floor anatomy and function in women without previous PFDs and whether it may be concerned as PFD prophylaxis tool. MATERIALS AND METHODS: The present analysis is a prospective, non-randomized case-control study from January 2014 to September 2017. Participants underwent pelvic floor ultrasound examination with bladder neck position estimation at rest, during levator ani tension, and at Valsalva maneuver before surgery and 12–18 months after. Pelvic organ prolapse quantification (POPQ) > 2 stage and PFD complaints were the exclusion criteria. RESULTS: Fifty-nine patients underwent bariatric surgery (57 sleeve gastrectomy and 2 gastric bypass). Mean BMI decreased from 43.8 ± 5.9 to 29 ± 4.6 kg/m(2) after surgery (p < 0.001). Statistically significant higher position of the bladder neck at rest, during tension, and at Valsalva maneuver (p < 0.05) was shown after surgery. We did not demonstrate differences in bladder neck mobility and bladder neck elevation at tension after weight loss. CONCLUSIONS: Bariatric surgery is associated with a betterment of bladder neck position at rest, tension, and Valsalva maneuver in women without PFDs. We postulate that bariatric surgery may be a tool for PFD prevention. It does not improve levator ani function and does not limit bladder neck mobility, which implicates that it has no influence on preexisting pelvic dysfunction.
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spelling pubmed-59739942018-06-08 Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders? Pomian, Andrzej Majkusiak, Wojciech Lisik, Wojciech Tomasik, Paweł Horosz, Edyta Zwierzchowska, Aneta Kociszewski, Jacek Barcz, Ewa Obes Surg Original Contributions INTRODUCTION: Obesity is one of the well-documented risk factors of pelvic floor disorders (PFDs). The PFDs include urinary and fecal incontinence (UI, FI) and pelvic organ prolapse (POP). Surgery-induced weight loss improves different kinds of incontinence as well as POP symptoms. However, there is a lack of evidence how bariatric surgery influences pelvic floor anatomy and function in women without previous PFDs and whether it may be concerned as PFD prophylaxis tool. MATERIALS AND METHODS: The present analysis is a prospective, non-randomized case-control study from January 2014 to September 2017. Participants underwent pelvic floor ultrasound examination with bladder neck position estimation at rest, during levator ani tension, and at Valsalva maneuver before surgery and 12–18 months after. Pelvic organ prolapse quantification (POPQ) > 2 stage and PFD complaints were the exclusion criteria. RESULTS: Fifty-nine patients underwent bariatric surgery (57 sleeve gastrectomy and 2 gastric bypass). Mean BMI decreased from 43.8 ± 5.9 to 29 ± 4.6 kg/m(2) after surgery (p < 0.001). Statistically significant higher position of the bladder neck at rest, during tension, and at Valsalva maneuver (p < 0.05) was shown after surgery. We did not demonstrate differences in bladder neck mobility and bladder neck elevation at tension after weight loss. CONCLUSIONS: Bariatric surgery is associated with a betterment of bladder neck position at rest, tension, and Valsalva maneuver in women without PFDs. We postulate that bariatric surgery may be a tool for PFD prevention. It does not improve levator ani function and does not limit bladder neck mobility, which implicates that it has no influence on preexisting pelvic dysfunction. Springer US 2017-12-18 2018 /pmc/articles/PMC5973994/ /pubmed/29256106 http://dx.doi.org/10.1007/s11695-017-3067-x Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Contributions
Pomian, Andrzej
Majkusiak, Wojciech
Lisik, Wojciech
Tomasik, Paweł
Horosz, Edyta
Zwierzchowska, Aneta
Kociszewski, Jacek
Barcz, Ewa
Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?
title Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?
title_full Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?
title_fullStr Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?
title_full_unstemmed Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?
title_short Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?
title_sort is bariatric surgery a prophylaxis for pelvic floor disorders?
topic Original Contributions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973994/
https://www.ncbi.nlm.nih.gov/pubmed/29256106
http://dx.doi.org/10.1007/s11695-017-3067-x
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