Morbid obesity adversely impacts pelvic floor function in females seeking attention for weight loss surgery

PURPOSE: This study was designed to determine the impact of excess body mass on the prevalence of pelvic floor disorders in morbidly obese females. METHODS: A total of 358 morbidly obese females (body mass index (BMI)≥35 kg/m²) completed two validated, condition-specific, quality of life questionnaires of pelvic floor dysfunction, which assessed stress/impact in three main domains of pelvic floor disorders: pelvic organ prolapse, colorectal-anal, and urogenital incontinence. Prevalence and severity scores in the study population were compared with data from 37 age-matched nonobese controls (BMI≤35 kg/m²). RESULTS: Mean age was 43±11 years vs. 42±12 years, and mean BMI was 50±10 kg/m² vs. 26±4 kg/m² (p=0.02) in the study and control groups, respectively. Parity and past obstetric history were similar between the groups. Pelvic floor disorders were prevalent in 91 percent of the morbidly obese females compared with 22 percent in the control group (p<0.001). Scores were statistically significantly higher in the study group for all studied stress/impact domains (p<0.001 and p=0.001, respectively). Further stratifications in the study group revealed a significant impact on pelvic floor disorders with increased age (p<0.003 and p<0.009 for stress/impact mean scores, respectively) and the presence of other comorbidities (p<0.008, p<0.03 for stress/impact prevalence, respectively). Additional increases in BMI>35 kg/m² did not show increased adverse impacts on pelvic floor disorders symptoms. CONCLUSION: More than 90 percent of morbidly obese females experience some degree of pelvic floor disorders, and 50 percent of these females report that symptoms adversely impact quality of life. In morbidly obese females, obesity is as important as obstetric history in predicting pelvic floor dysfunction.