Another link in the chain- Diet, digestive health, and pelvic floor integrity: A cross-cultural study

To explore the association between impaired bowel function (IBF), diet and their collective impact on the incidence of different pelvic organ prolapse (POP) compartments.

This cross-sectional, international, multi-center study was conducted among patients undergoing pelvic floor repair in Ireland and Israel. Adherence to the Mediterranean diet and the presence of IBF were assessed using validated questionnaires (The Mediterranean Diet Adherence Questionnaire and the Patient Assessment of Constipation Symptoms, respectively). General demographic information, clinical details, and intraoperative data were extracted from the electronic medical records in each hospital. A univariate analysis was followed by a multivariate one, and correlations were assessed using Spearman's rho coefficient.

Among the 204 patients enrolled, 105 (51.5 %) were categorized into the IBF group, and 99 (48.5 %) into the NBF group. There was no difference in age, parity, body mass index and obesity rate between groups. Patients in the IBF group were more often nullipara (1 % Vs. 8.1 %, p = 0.01) and exhibited significantly lower rates of adherence to the Mediterranean diet than the NBF group (22.0 % vs. 70.5 %, p = 0.01). Cystocele, cul-de-sac (enterocele), and genital hiatus prolapse were more prevalent in the IBF group. The distribution of surgical repair procedures was similar between the two groups. Multivariate logistic regression analysis revealed a significant association between surgical repair involving the anterior wall and low adherence to the Mediterranean diet.

This study suggests that IBF and constipation shows specific patterns of vaginal wall prolapse as cystocele and enterocele, underscoring the importance of dietary habits in the prevention and management of pelvic floor disorders.