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Are Obese Patients at an Increased Risk of Pelvic Floor Dysfunction Compared to Non-obese Patients?

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Abstract

Purpose

Factors associated with increased intra-abdominal pressure such as chronic cough, morbid obesity, and constipation may be related to pelvic floor dysfunction. In this study, we compared anorectal manometry values and clinical data of class II and III morbidly obese patients referred to bariatric surgery with that of non-obese patients.

Methods

We performed a case-matched study between obese patients referred to bariatric surgery and non-obese patients without anorectal complaints. The groups were matched by age and gender. Men and nulliparous women with no history of abdominal or anorectal surgery were included in the study. Anorectal manometry was performed by the stationary technique, and clinical evaluation was based on validated questionnaires.

Results

Mean age was 44.8 ± 12.5 years (mean ± SD) in the obese group and 44.1 ± 11.8 years in the non-obese group (p = 0.829). In the obese group, 65.4% of patients had some degree of fecal incontinence. Mean squeeze pressure was significantly lower in obese than in non-obese patients (155.6 ± 64.1 vs. 210.1 ± 75.9 mmHg, p = 0.004), and there was no significant difference regarding mean rest pressure in obese patients compared to non-obese ones (63.7 ± 23.1 vs. 74.1 ± 21.8 mmHg, p = 0.051). There were no significant differences in anorectal manometry values between continent and incontinent obese patients.

Conclusions

The prevalence of fecal incontinence among obese patients was high regardless of age, gender, and body mass index. Anal squeeze pressure was significantly lower in obese patients compared to non-obese controls.

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Authors and Affiliations

  1. Department of Gastroenterology, Colorectal Surgery Service, Obesity and Metabolic Surgery Service, School of Medicine, Hospital das Clínicas of University of São Paulo, 31, Fabia Street #101, São Paulo, SP, 05051-030, Brazil

    Isaac José Felippe Corrêa Neto, Rodrigo Ambar Pinto, José Marcio Neves Jorge, Marco Aurélio Santo, Leonardo Alfonso Bustamante-Lopez, Ivan Cecconello & Sérgio Carlos Nahas

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  1. Isaac José Felippe Corrêa Neto
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  2. Rodrigo Ambar Pinto
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  3. José Marcio Neves Jorge
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  4. Marco Aurélio Santo
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  6. Ivan Cecconello
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  7. Sérgio Carlos Nahas
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Correspondence to Isaac José Felippe Corrêa Neto.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the Institutional Review Board (IRB) at the University of São Paulo School of Medicine (FMUSP), São Paulo, Brazil.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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No funding.

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Neto, I.J.F.C., Pinto, R.A., Jorge, J.M.N. et al. Are Obese Patients at an Increased Risk of Pelvic Floor Dysfunction Compared to Non-obese Patients?. OBES SURG 27, 1822–1827 (2017). https://doi.org/10.1007/s11695-017-2559-z

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  • DOI: https://doi.org/10.1007/s11695-017-2559-z

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