Obesity and pelvic organ prolapse
Open accessAbstract
PURPOSE OF REVIEW: The purpose of this review is to review the data on the relationship of obesity and pelvic organ prolapse (POP). This review is timely and relevant as the prevalence of obesity is increasing worldwide, and it is an important risk factor to consider in counseling women on management of prolapse symptoms and outcomes for surgical treatment. RECENT FINDINGS: The main findings in the literature include: Obesity is increasing worldwide and impacts health, social life, work and healthcare costs. Elevated BMI is an important lifestyle factor affecting pelvic prolapse. The most probable mechanism of POP development among obese women is the increase in intra-abdominal pressure that causes weakening of pelvic floor muscles and fascia. Obesity is associated with significant pelvic floor symptoms and impairment of quality of life (QOL). Weight loss is likely not associated with anatomic improvement, but may be associated with prolapse symptom improvement. Weight loss should be considered a primary option in obese women for its beneficial effects on multiple organ systems and reducing pelvic floor disorder (PFD) symptoms. Although the operation time in obese women is significantly longer than in healthy weight women, the complication rate of surgery has not been shown to be increased compared to nonobese patients, regardless of route of surgery. There are data to support the vaginal approach in obese women. Some studies have shown that women with high body weight are associated with an increase in the risk for both anatomical and functional recurrence, and other studies have shown no difference. SUMMARY: Obesity is a prevalent modifiable condition that impacts PFDs including pelvic prolapse. Patients should be counseled using clinical judgment, knowledge of the literature and with the goal of improving QOL.
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Schulten, S. F. M., Claas-Quax, M. J., Weemhoff, M., van Eijndhoven, H. W., van Leijsen, S. A., Vergeldt, T. F., IntHout, J., & Kluivers, K. B. (2022) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.04.046 · Cited by 245 · see citing works
“For primary POP, 2 studies reported BMI as a risk factor.(50,51) On the contrary, the systematic review by Zenebe et al(52) found no association between BMI and primary POP.”
BackgroundSelf-citationImpact of Lifestyle Modifications on the Prevention and Treatment of Pelvic Organ Prolapse
Jeppson, P. C., Balgobin, S., Wheeler, T., Forner, L., Caagbay, D., Thompson, J., Muffly, T. M., Meyer, I., Beestrum, M., Collins, S., et al. (2025) · International Urogynecology Journal · doi:10.1007/s00192-024-05992-0 · Cited by 8 · see citing works
Mitchell, J. R., Brancaccio, H. E., Blusewicz Spt, M., Lo, D. F., Goodwin, B., & Carey, D. (2025) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2024.116111 · Cited by 4 · see citing works
- Authors
- Lee, U. J., Kerkhof, M. H., van Leijsen, S. A., & Heesakkers, J. P.
- Affiliations
- Virginia Mason Medical Center (US)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Radboud University Medical Center (NL)
- Corresponding author
- Lee, Una J.
- Venue
- Current Opinion in Urology
- Published
- 2017-09
- Volume
- 27
- Issue
- 5
- Pages
- 428-434
- ISSN
- 0963-0643 (ISSN-L)
- OpenAlex
- W2735643589
- Cited by
- 74
- References
- 48
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 9 · 2023: 13 · 2022: 10 · 2021: 8 · 2020: 7 · 2019: 8 · 2018: 2 · 2017: 2
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- other-oa
- Locations
- Current Opinion in Urology (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- obesity, pelvic organ prolapse, body mass index, intra-abdominal pressure, pelvic floor dysfunction, weight loss, quality of life, prolapse recurrence, surgical complications, prolapse surgery
- MeSH terms
- Female, Humans, Obesity, Quality of Life, Urinary Incontinence, Prevalence, Pelvic Floor, Pelvic Organ Prolapse
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