Skip to main content

Advertisement

SpringerLink
Log in

Obesity: how much does it matter for female pelvic organ prolapse?

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The objective was to determine the association between body mass index (BMI) and symptoms and signs of female pelvic organ prolapse (POP).

Methods

An observational cross-sectional study of 964 archived datasets of women seen for symptoms and signs of lower urinary tract and pelvic organ dysfunction between September 2011 and February 2014 at a tertiary urogynaecology centre in Australia was carried out. An in-house standardised interview, the International Continence Society Pelvic Organ Prolapse Quantification (ICS POP-Q) and 4-D translabial ultrasound, followed by analysis of ultrasound volumes for pelvic organ descent and hiatal area on Valsalva, were performed, blinded against other data.

Results

There is a positive association between BMI and posterior compartment prolapse on clinical examination and ultrasound imaging, but not for the anterior and central compartments. There was no association with prolapse symptom bother and a negative association with symptoms of prolapse.

Conclusions

In this observational study, we found a strong association between all tested measures of posterior compartment descent and BMI, both clinical and on imaging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Glazener C, Elders A, Macarthur C, Lancashire RJ, Herbison P, Hagen S, et al. Childbirth and prolapse: long-term associations with the symptoms and objective measurement of pelvic organ prolapse. Br J Obstet Gynaecol. 2013;120(2):161–8.

    Article  CAS  Google Scholar 

  2. Gyhagen M, Bullarbo M, Nielsen TF, Milsom I. Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. Br J Obstet Gynaecol. 2013;120(2):152–60.

    Article  CAS  Google Scholar 

  3. Smith FJ, Holman CDJ, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 2010;116(5):1096–100.

    Article  PubMed  Google Scholar 

  4. Barber M, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24(11):1783–90.

    Article  PubMed  Google Scholar 

  5. Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JOL, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10–7.

    Article  PubMed  CAS  Google Scholar 

  6. Dietz HP. The aetiology of prolapse. Int Urogynecol J. 2008;19(10):1323–9.

    Article  CAS  Google Scholar 

  7. Vergeldt TF, Weemhoff M, IntHout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015;26(11):1559–73.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. Pelvic organ prolapse in the women’s health initiative: gravity and gravidity. Am J Obstet Gynecol. 2002;186(6):1160–6.

    Article  PubMed  Google Scholar 

  9. Swift S, Woodman P, O’Boyle A, Kahn M, Valley M, Bland D, et al. Pelvic organ support study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005;192(3):795–806.

    Article  PubMed  Google Scholar 

  10. Wu JM, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in U.S. women: 2010 to 2050. Obstet Gynecol. 2009;114(6):1278–83.

    Article  PubMed  Google Scholar 

  11. Washington BB, Erekson EA, Kassis NC, Myers DL. The association between obesity and stage II or greater prolapse. Am J Obstet Gynecol. 2010;202(5):503.e1–4.

    Article  Google Scholar 

  12. Anonymous. Overweight and obesity. Commonwealth of Australia; Australian Bureau of Statistics; http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/bySubject/4338.0~2011-13~MainFeatures~Overweightandobesity~10007

  13. Ulrich D, Guzman Rojas R, Dietz H, Mann K, Trutnovsky G. Use of a visual analog scale for evaluation of bother from pelvic organ prolapse. Ultrasound Obstet Gynecol. 2014;43(6):693–7.

    Article  PubMed  CAS  Google Scholar 

  14. Dietz HP. Ultrasound imaging of the pelvic floor. II: Three-dimensional or volume imaging. Ultrasound Obstet Gynecol. 2004;23(6):615–25.

    Article  PubMed  CAS  Google Scholar 

  15. Ornö A, Dietz HP. Levator co-activation is a significant confounder of pelvic organ descent on Valsalva maneuver. Ultrasound Obstet Gynecol. 2007;30(3):346–50.

    Article  PubMed  Google Scholar 

  16. Dietz HP, Mann KP. What is clinically relevant prolapse? An attempt at defining cutoffs for the clinical assessment of pelvic organ descent. Int Urogynecol J. 2014;25(4):451–5.

    Article  PubMed  CAS  Google Scholar 

  17. Dietz H, Haylen B, Broome J. Ultrasound in the quantification of female pelvic organ prolapse. Ultrasound Obstet Gynecol. 2001;18(5):511–4.

    Article  PubMed  CAS  Google Scholar 

  18. Shek KL, Dietz HP. What is abnormal uterine descent on translabial ultrasound? Int Urogynecol J. 2015;26(12):1783–7.

    Article  PubMed  Google Scholar 

  19. Dietz HP, Steensma AB. Posterior compartment prolapse on two-dimensional and three-dimensional pelvic floor ultrasound: the distinction between true rectocele, perineal hypermobility and enterocele. Ultrasound Obstet Gynecol. 2005;26(1):73–7.

    Article  PubMed  CAS  Google Scholar 

  20. World Health Organisation. Obesity: preventing and managing the global epidemic. 2000. http://apps.who.int/bmi/index.jsp?introPage=intro_3.html. Accessed 19 October 2016.

  21. Braverman M, Turel F, Friedman T, Kamisan Atan I, Dietz HP. Does patient posture affect the sonographic evaluation of pelvic organ prolapse? Ultrasound Obstet Gynecol. 2016;48(Suppl 1):8.

    Google Scholar 

  22. Handa VL, Garrett E, Hendrix S, Gold E, Robbins J. Progression and remission of pelvic organ prolapse: a longitudinal study of menopausal women. Am J Obstet Gynecol. 2004;190(1):27–3.

    Article  PubMed  Google Scholar 

  23. Whitcomb EL, Lukacz ES, Lawrence JM, Nager CW, Luber KM. Prevalence and degree of bother from pelvic floor disorders in obese women. Int Urogynecol J. 2009;20(3):289–94.

    Article  Google Scholar 

  24. Noblett KL, Jensen JK, Ostergard DR. The relationship of body mass index to intra-abdominal pressure as measured by multichannel Cystometry. Int Urogynecol J. 1997;8(6):323–6.

    Article  CAS  Google Scholar 

  25. Dietz HP, Simpson JM. Levator trauma is associated with pelvic organ prolapse. Br J Obstet Gynaecol. 2008;115:979–84.

    Article  CAS  Google Scholar 

  26. Orejuela F, Shek KL, Dietz HP. The time factor in the assessment of prolapse and levator ballooning. Int Urogynecol J. 2012;23(2):175–8.

    Article  PubMed  Google Scholar 

  27. Mulder F, Shek KL, Dietz HP. The pressure factor in the assessment of pelvic organ mobility. Aust NZ J Obstet Gynaecol. 2012;52:282–5.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Andrew Martin, PhD, Senior Biostatistician at NHMRC Clinical Trials Centre, University of Sydney, for his help with the statistical analysis

Funding

This study was unfunded.

Author information

Authors and Affiliations

  1. Department of Gynaecology, Monash Health, Melbourne, Australia

    Natharnia Young

  2. Department of Obstetrics & Gynaecology, Monash Health, 823-865 Centre Road, Bentleigh East, VIC, Australia

    Natharnia Young

  3. Sydney Medical School Nepean, Nepean Hospital, Penrith, Australia

    Ixora Kamisan Atan, Rodrigo Guzman Rojas & Hans Peter Dietz

  4. Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia

    Ixora Kamisan Atan

  5. Unidad de Piso Pélvico Femenino, Departamento de Ginecología y Obstetricia, Hospital Clínico Universidad de Chile, Santiago, Chile

    Rodrigo Guzman Rojas

  6. Departamento de Ginecología y Obstetricia, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile

    Rodrigo Guzman Rojas

Authors
  1. Natharnia Young
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ixora Kamisan Atan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rodrigo Guzman Rojas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hans Peter Dietz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Natharnia Young.

Ethics declarations

Financial disclaimer/conflicts of interest

HP Dietz has received unrestricted educational grants and honoraria from GE Medical. None of the other authors has any conflicts of interest to declare.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Young, N., Atan, I.K., Rojas, R.G. et al. Obesity: how much does it matter for female pelvic organ prolapse?. Int Urogynecol J 29, 1129–1134 (2018). https://doi.org/10.1007/s00192-017-3455-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-017-3455-8

Keywords

Search

Navigation