Obesity and Pelvic Floor Dysfunction: Battling the Bulge

Area of Science:

• Urogynecology
• Obesity Medicine
• Women's Health

Background:

• Pelvic floor disorders (PFDs) are common in women, encompassing urinary incontinence, pelvic organ prolapse, and fecal incontinence.
• Obesity disproportionately affects women with PFDs, with over 50% of women with BMI > 35 kg/m² reporting symptoms.
• Limited research exists on tailoring PFD treatments for obese populations.

Purpose of the Study:

• To review the impact of obesity on PFDs.
• To outline current knowledge on PFD treatment implications in obese women.

Main Methods:

• A literature review was conducted on the incidence and treatment of PFDs in obese populations.

Main Results:

• Nonsurgical and surgical weight loss positively impacts all PFDs.
• Obese women benefit from pelvic floor training, biofeedback, and pharmacologic treatments for incontinence.
• Surgical treatments for stress urinary incontinence and prolapse show good success rates in obese women, with no increased risks.
• Pessaries are effective for prolapse and stress urinary incontinence in obese women.

Conclusions:

• Despite limited research, obese women demonstrate good treatment outcomes for PFDs.
• Further research is essential to optimize counseling and treatment strategies for obese patients with PFDs.
• Addressing the obesity epidemic requires tailored approaches to managing PFDs.