Association of Obesity with Pelvic Floor Disorders and its effect on the Quality of Life in women awaiting Bariatric Surgery

Objectives: To assess the association of obesity with frequency of pelvic floor disorders (PFDs) and their effects on quality of life (QoL) in obese women Design: A case-matched study Setting: University hospital in Saudi Arabia between October 2014 and October 2015 Subjects: Seventy-five obese (BMI > 30 kg/m(2)) women awaiting bariatric surgery and 91 age and parity-matched, non-obese controls were selected. Intervention: Three validated disease-specific and QoL questionnaires about PFD (PFDI-20, PFIQ-7 and International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI)) were administered to all participants. Main outcome measures: The frequency of PFD and the effect on QoL. Data were analyzed by chi-square and t-test. Results: Overall, PFDs were frequently present in 47 (62.7%) women in the obese group compared to 30 (32.9%) in the non-obese group (odds ratio = 3.41, 95% confidence interval: 1.79 - 6.48, p < 0.001). Obese women were found to experience symptoms of pelvic organ prolapse (POP) (p < 0.001), stress urinary incontinence (p = 0.003) and fecal incontinence (p = 0.011) as compared to non-obese women. Regarding the different QoL questionnaires, total mean scores of PFDI and ICIQ were statistically higher in the obese group compared with non-obese women. Conclusion: The frequency of POP, urinary incontinence, and fecal incontinence was increased in obese women awaiting bariatric surgery. Low self-esteem and limited religious activities were the most negative impacts of these symptoms on QoL.