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Effects of bariatric surgery on pelvic floor disorders in obese women: a meta-analysis

Archives of Gynecology and Obstetrics volume 296, pages 181–189 (2017)Cite this article

Abstract

Purpose

Obesity is an established risk factor for pelvic floor disorders (PFD) but the effects of bariatric surgery on PFD are uncertain. This meta-analysis was conducted to evaluate the effects of bariatric surgery on PFD in obese women.

Methods

A systematic search of PubMed, Cochrane Library, CNKI and CBM databases up to October 2016 was performed, and studies reporting pre-operative and post-operative outcomes in obese women undergoing bariatric surgery were included. The Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Incontinence Questionnaire (PFIQ-7), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Female Sexual Function Index and the International Consultation on Incontinence Questionnaire-Urinary Incontinence short form score were used for evaluating pelvic floor dysfunction after bariatric surgery.

Results

Eleven cohort studies were finally included. Pooled results revealed that bariatric surgery was associated with a significant improvement in PFD for obese women on the whole [PFDI-20: SMD = 0.89, 95% CI (0.44, 1.34), P < 0.001; PFIQ-7: SMD = 1.23, 95% CI (0.17, 2.29), P = 0.023]. In the subscale analysis, there was significant improvement in urinary incontinence and pelvic organ prolapse. However, no significant improvement was found in fecal incontinence and sexual function.

Conclusions

Bariatric surgery is associated with significant improvement in urinary incontinence, and has a benefit on pelvic organ prolapse for obese women. However, there is no significant improvement in fecal incontinence and sexual function. Further multi-center, large-scale and longer-term randomized controlled trials are needed to confirm these results.

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Affiliations

  1. Department of Urology, Zhongshan Affiliated Hospital of Sun Yat-sen University, Zhongshan, Guangdong, China

    Wenqing Lian, Yiqun Zheng, Hongxing Huang & Bin Cao

  2. Department of Rehabilitation Medical, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China

    Lianghua Chen

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  1. Wenqing Lian
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  2. Yiqun Zheng
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  3. Hongxing Huang
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Author contributions

WL: project development, data collection, data analysis, manuscript writing. YZ: data collection, data analysis. HH: data collection, data analysis. LC: data collection. BC: data analysis.

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Correspondence to Wenqing Lian.

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Lian, W., Zheng, Y., Huang, H. et al. Effects of bariatric surgery on pelvic floor disorders in obese women: a meta-analysis. Arch Gynecol Obstet 296, 181–189 (2017). https://doi.org/10.1007/s00404-017-4415-8

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  • DOI: https://doi.org/10.1007/s00404-017-4415-8

Keywords

  • Bariatric surgery
  • Pelvic floor disorders
  • Urinary incontinence
  • Pelvic organ prolapse
  • Fecal incontinence