Role of bariatric surgery in the pelvic floor disorders

Abstract

Pelvic floor disorders are very frequent among women. Weight loss can help them to achieve urinary and faecal continence again. In this narrative review, the possible mechanisms of pelvic floor disorders in obese women, their symptoms and the role of bariatric sur- gery in changing their quality of life are presented. We retrieved the included results of our study after per- forming a systematic, electronic search in PubMed (De- cember 17, 2012) and Scopus (December 17, 2012). The main mechanism causing the development of pelvic floor disorders is chronically increased abdominal pressure as it overts structural damage or neurologic dysfunction predisposing to prolapse and incontinence. The symptoms include a sensation of vaginal fullness or pressure, uterine descent, sacral back pain with stand- ing, vaginal spotting from ulceration of the protruding cervix or vagina, coital difficulty, lower abdominal dis- comfort, and voiding and defecatory difficulties. Evi- dence indicates that massive weight loss (45 to 50 kg) improves incontinence in morbidly obese women after bariatic surgery. Faecal incontinence is also improved after bariatric surgery. This review highlights the role of bariatric surgery in weight reduction of obese women that could act as a treatment for the pelvic floor disor- ders faced by those women offering improvement in incontinence as well as quality of life.