Résumé
L’obésité est maintenant reconnue comme facteur de risque de désordres pelviens (DP). Les DP comprennent l’incontinence urinaire (IU), l’existence d’un prolapsus organique pelvien et l’incontinence anale (IA). Ils sont associés à une altération significative de la qualité de vie (QDV). L’IA est significativement plus souvent présente chez l’obèse, en règle associée à l’IU. L’hyperpression abdominale associée à l’obésité est un des mécanismes de l’IA. La correction de l’obésité est un traitement curatif et préventif de l’IA.
Abstract
Obesity is now recognized as a risk factor for pelvic floor disorders (PFD). PFD are urinary incontinence, pelvic organ prolapse, and anal incontinence. PFD have significant impact on quality of life. Anal incontinence is more present in obese patients, usually associated with urinary incontinence. Abdominal hyperpression caused by obesity is responsible for anal incontinence. Weight loss is associated with improvement of anal incontinence.
Références
Ogden CL, Carroll MD, Curtin LR, et al (2006) Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 295:1549–55
Macmillan AK, Merrie AE, Marshall RJ, Parry BR (2004) The prevalence of fecal incontinence in community-dwelling adults: a systematic review of the literature. Dis Colon Rectum 47:1341–9
Denis P, Bercoff E, Bizien MF, et al (1992) [Prevalence of anal incontinence in adults]. Gastroenterol Clin Biol 16:344–50
Damon H, Guye O, Seigneurin A, et al (2006) Prevalence of anal incontinence in adults and impact on quality of life. Gastroenterol Clin Biol 30:37–43
Uustal Fornell E, Wingren G, Kjolhede P (2004) Factors associated with pelvic floor dysfunction with emphasis on urinary and fecal incontinence and genital prolapse: an epidemiological study. Acta Obstet Gynecol Scand 83:383–9
Wasserberg N, Haney M, Petrone P, et al (2007) Morbid obesity adversely impacts pelvic floor function in females seeking attention for weight loss surgery. Dis Colon Rectum 50:2096–103
Wasserberg N, Haney M, Petrone P, et al (2008) Fecal incontinence among morbid obese women seeking for weight loss surgery: an underappreciated association with adverse impact on quality of life. Int J Colorectal Dis 23:493–7
Abramov Y, Sand PK, Botros SM, et al (2005) Risk factors for female anal incontinence: new insight through the Evanston-Northwestern Twin Sisters Study. Obstet Gynecol 106:726–32
Richter HE, Burgio KL, Clements RH, et al (2005) Urinary and anal incontinence in morbidly obese women considering weight loss surgery. Obstet Gynecol 106:1272–7
Lawrence JM, Lukacz ES, Liu IL, et al (2007) Pelvic floor disorders, diabetes, and obesity in women: findings from the Kaiser Permanente Continence Associated Risk Epidemiology Study. Diabetes Care 30:2536–41
Varma MG, Brown JS, Creasman JM, et al (2006) Fecal incontinence in females older than aged 40 years: who is at risk? Dis Colon Rectum 49:841–51
Nygaard I, Barber MD, Burgio KL, et al (2008) Prevalence of symptomatic pelvic floor disorders in US women. JAMA 300:1311–6
Kim S, Harvey MA, Johnston S (2005) A review of the epidemiology and pathophysiology of pelvic floor dysfunction: do racial differences matter? J Obstet Gynaecol Can 27:251–9
Markland AD, Richter HE, Burgio KL, et al (2009) Fecal incontinence in obese women with urinary incontinence: prevalence and role of dietary fiber intake. Am J Obstet Gynecol 200:566 e1-6
Chen CC, Gatmaitan P, Koepp S, et al (2009) Obesity is associated with increased prevalence and severity of pelvic floor disorders in women considering bariatric surgery. Surg Obes Relat Dis 5:411–5
Altman D, Falconer C, Rossner S, Melin I (2007) The risk of anal incontinence in obese women. Int Urogynecol J Pelvic Floor Dysfunct 18:1283–9
Erekson EA, Sung VW, Myers DL (2008) Effect of body mass index on the risk of anal incontinence and defecatory dysfunction in women. Am J Obstet Gynecol 198:596 e1-4
Whitcomb EL, Lukacz ES, Lawrence JM, et al (2009) Prevalence and degree of bother from pelvic floor disorders in obese women. Int Urogynecol J Pelvic Floor Dysfunct 20:289–94
Noblett KL, Jensen JK, Ostergard DR (1997) The relationship of body mass index to intra-abdominal pressure as measured by multichannel cystometry. Int Urogynecol J Pelvic Floor Dysfunct 8:323–6
Lambert DM, Marceau S, Forse RA (2005) Intra-abdominal pressure in the morbidly obese. Obes Surg 15:1225–32
Sanchez NC, Tenofsky PL, Dort JM, et al (2001) What is normal intra-abdominal pressure? Am Surg 67:243–8
De Keulenaer BL, De Waele JJ, Powell B, Malbrain ML (2009) What is normal intra-abdominal pressure and how is it affected by positioning, body mass and positive and expiratory pressure? Intensive Care Med 35:969–76
Nygaard IE, Thompson FL, Svengalis SL, Albright JP (1994) Urinary incontinence in elite nulliparous athletes. Obstet Gynecol 84:183–7
Cummings JM, Rodning CB (2000) Urinary stress incontinence among obese women: review of pathophysiology therapy. Int Urogynecol J Pelvic Floor Dysfunct 11:41–4
Kapoor DS, Davila GW, Rosenthal RJ, Ghoniem GM (2004) Pelvic floor dysfunction in morbidly obese women: pilot study. Obes Res 12:1104–7
Fox M, Schwizer W, Menne D, et al (2004) The physical properties of rectal contents have effects on anorectal continence: insights from a study into the cause of fecal spotting on Orlistat®. Dis Colon Rectum 47:2147–56
Burgio KL, Richter HE, Clements RH, et al (2007) Changes in urinary and fecal incontinence symptoms with weight loss surgery in morbidly obese women. Obstet Gynecol 110: 1034–40
Subak LL, Whitcomb E, Shen H, et al (2005) Weight loss: a novel and effective treatment for urinary incontinence. J Urol 174:190–5
Kudish BI, Iglesia CB, Sokol RJ, et al (2009) Effect of weight change on natural history of pelvic organ prolapse. Obstet Gynecol 113:81–8
Greer WJ, Richter HE, Bartolucci AA, Burgio KL (2008) Obesity and pelvic floor disorders: a systematic review. Obstet Gynecol 112:341–9
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Soudan, D. Incontinence anale et obésité. Obes 5, 25–28 (2010). https://doi.org/10.1007/s11690-010-0221-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11690-010-0221-1