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UroGynecology

OBesity Project. UroGynecology. “ Obesity is a strong independent risk factor for urinary incontinence in adults. ”. Obesity and Urinary Incontinence. Obesity is a strong independent risk factor for UI in Adults There is a dose response effect of weight on UI:

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UroGynecology

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  1. OBesity Project UroGynecology

  2. “Obesity is a strong independent risk factor for urinary incontinence in adults.”

  3. Obesity and Urinary Incontinence • Obesity is a strong independent risk factor for UI in Adults • There is a dose response effect of weight on UI: • Each 5-unit increase in BMI associated with 20-70% increase in UI risk • Odds of incident UI during 5-10 years increased by 30-60% for each 5-unit increase in BMI

  4. Obesity and Urinary Incontinence • Adolescents • UI affects >10% of obese, adolescent girls • Incontinence severity scores are significantly higher in obese girls compared to non-obese peers • Women who are obese early in life more than double their risk of severe UI

  5. Treatment of Incontinence in Obese Women • Gold standard procedure for S(tress)UI is only 52% effective in very obese compared to 81% in non-obese women • Failure of Burch procedure within the first postop year is almost 4 times higher in women with a BMI >30 than in women of normal weight • Weight loss is strongly associated with decreasing incontinence and cost of treatment

  6. Obesity and Pelvic Organ Prolapse • Increased risk of Pelvic Organ Prolapse (POP) is strongly associated with obesity • Obesity is associated with progression of POP • Obesity is associated with increased “bother” resulting from POP

  7. Obesity and Pelvic Organ Prolapse • Treatment of POP in Obese Woman • Significantly longer operative times than healthy-weight women • In a cohort of women undergoing sacrocolpopexy for POP, obese women were younger, suggesting earlier onset of the disease state • Weight loss does not appear to be significantly associated with regression of POP

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