1. UROGYNECOLOGY OBesity Project

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