DROP OFF THE CURTAIN: IS OVERWEIGHTOR OBESITY REALLY IMPORTANT RISK FACTOR OF SYMPTOMATIC PELVIC ORGANPROLAPSE?
B. FARKAS1, P. GAL 1,J. BODIS 1, N. FARKAS 2, Z. NEMETH 3;
1Department of Obstetrics and Gyneacology, Univeristyof Pecs, Clinical Ctr., Pecs, Hungary, 2Institute ofBioanalysis, Univeristy of Pecs, Clinical Ctr., Pecs, Hungary, 3SaintJohn of God Hosp. Vienna, Dept. of G, Vienna, Austria.
Introduction: Obesity is agrowing worldwide epidemic, with increasing prevalence in bothchildren and adults, and the World Health Organization considers tobe the greatest public health issue of the 21st century. Overweightand obesity count to be important risk factors for numerous diseases.In the multifactorial aetiology of pelvic organ prolapse as well,increased BMI is considered to be the most consistent risk factoradjacent to vaginal childbirth and advancing age. We considered, thatthe association between obesity and prolapse severity has not yetbeen clearly defined.
Objective: We sought to evaluate theassociation between overweight/obesity and symptomatic pelvic organprolapse stage II and greater.
Methods: In a prospectivecohort study, 1977 women suffering from symptomatic POP wereincluded. Patients were intended to be treated either conservatively(n=833), or planned to udergo surgery (n=1144), and their data wascompared to 600 age, and parity matching women, with no prolapse, ascontrol, from January 2009 to December 2016. All patients sufferedfrom POP of stage 2 or higher either the anterior, middle orposterior compartment or in combinations. Overweight and obesity wasdetermined by calculating the body mass index (BMI). All patientsreported sensation of vaginal bulge with or without of symptoms ofurinary, bowel, or sexual dysfunction. Gynecologic medical historywas revealed, including the standard demographic data of thepatients, and analyzed using multivariate analysis by a professionalstatistician.
Results: The average age was 56 years ± 13SD (min: 22, max: 89), and the mean parity was 2.04 ± 0.95 SD perpatient (min: 0, max: 13). The study population had average weightand height, resulting in a mean BMI of 26.3 ± 7.14 kg/m2.Two third (66.2 %) of the study population was in premenopause, withan average BMI of 26.99 ± 8.05 kg/m2, and postmenopausepatients (33.8%) the BMI was found to be 24.95 ± 4.65 kg/m2respectively. Multivariate analysis revealed no statisticalsignificant difference compared with the control group.
Conclusions:In this study we did not found significant statistical differencesbetween the BMI values of symptomatic POP patients and the controlpopulation. Our data suggest that in Caucasian Eastern-Europeanpopulation overweight and obesity might not act as important riskfactors in the development of pelvic organ prolapse. It seems thatdifferent aspects of pelvic floor dysfunction may have differentimportant risk factors.
References: “Higher body massindex has been associated with POP.” ,,Overweight and obese womenare at high risk of developing POP, with odds ratio of 2,51 and 2,56,respectively.” ,,Overweight and obesity were strongly associatedwith both urinary and fecal incontinence but not with symtomps ofgenital prolapse.”