Wenqing Lian1, Yiqun Zheng2, Hongxing Huang2, Lianghua Chen3, Bin Cao2. 1. Department of Urology, Zhongshan Affiliated Hospital of Sun Yat-sen University, Zhongshan, Guangdong, China. lianwenqingzsph@sina.com. 2. Department of Urology, Zhongshan Affiliated Hospital of Sun Yat-sen University, Zhongshan, Guangdong, China. 3. Department of Rehabilitation Medical, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.
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.
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 obesewomen. 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 obesewomen 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 obesewomen 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 obesewomen. 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.
Authors: Adil E Bharucha; Charles H Knowles; Isabelle Mack; Allison Malcolm; Nicholas Oblizajek; Satish Rao; S Mark Scott; Andrea Shin; Paul Enck Journal: Nat Rev Dis Primers Date: 2022-08-10 Impact factor: 65.038
Authors: Andrzej Pomian; Wojciech Majkusiak; Wojciech Lisik; Paweł Tomasik; Edyta Horosz; Aneta Zwierzchowska; Jacek Kociszewski; Ewa Barcz Journal: Obes Surg Date: 2018-06 Impact factor: 4.129
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