This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The purpose of this study is to prospectively evaluate the effect of weight loss surgery on the pelvic health of 60 morbidly obese female subjects. The long term goals are to evaluate the effect of massive weight loss after bariatric surgery on the urinary tract, pelvic organ prolapse, colorectal and sexual function. Obesity currently involves 30% of the U.S. population, and there have been few studies designed to evaluate these parameters in a prospective fashion. The hypothesis is that massive weight loss will impact on urinary incontinence, pelvic organ prolapse, and sexual function due to decreased intra-abdominal forces impacting on the pelvis. We base this hypothesis on the observations that 1) weight loss after bariatric surgery has been associated with a subjective and objective improvement in urinary incontinence, 2) obesity has been shown to be a risk factor for pelvic organ prolapse and 3) obesity has been shown to be associated with decreased sexual activity, desire, lubrication, arousal, satisfaction, and performance.
The specific aims of this project are to evaluate bariatric surgery, with subsequent weight loss on the following:1. Subjective outcome measures of urinary incontinence, pelvic organ prolapse, colorectal and sexual function. We will use the Pelvic Floor Impact Questionnaire (PFIQ) which is a validated quality of life instrument that has urinary, prolapse and colorectal subscales. We will also use the Pelvic Organ Prolapse/Urinary Incontinence Questionnaire (PISQ-12) and the Female Sexual Function Inventory (FSFI) to evaluate sexual function.2. Objective outcome measures of urinary incontinence. Subjects that screen positive on the incontinence subscale of the PFIQ will be examined serially at baseline, 6 and 12 months post-operatively using the empty cough stress test, 300cc cough stress test, simple urodynamics, and post void residual (PVR). 3. Objective outcome measures of pelvic organ prolapse. Subjects that screen positive for pelvic organ prolapse subscale of the PFIQ will be examined serially with pelvic organ prolapse quantitation (POPQ) and urethral axis determination using the cotton swab test, performed at baseline, 6 and 12 months post operatively. Hypothesis: The hypothesis is that massive weight loss will impact on urinary incontinence, pelvic organ prolapse, and sexual function due to decreased intra-abdominal forces impacting on the pelvis.
Showing the most recent 10 out of 869 publications
