Association of body composition with the symptoms of pelvic floor disorders in middle-aged women: A longitudinal study

Objective: To investigate the association of body composition with symptoms of pelvic floor disorders ie, stress urinary incontinence, urgency urinary incontinence, fecal incontinence, and feeling of pelvic organ prolapse among middle-aged women. Methods: A longitudinal study with two measurement points 4 years apart was performed using a population sample of 376 Finnish women aged 47 to 55 years at the baseline. Total and regional body composition was assessed with dual x-ray absorptiometry (DXA) and multifrequency bioelectrical impedance analyzer (BIA). Body height, weight, and waist circumference were measured, and body mass index (BMI) was calculated. The symptoms of pelvic floor disorders were assessed using self-report questionnaire. Generalized estimating equations models were used to investigate associations. Models were adjusted with demographical, gynecologic, and physical activity variables. Results: The change in body composition was not associated with the change in the symptoms of pelvic floor disorders after 4-year follow-up. In cross-sectional analysis, the symptoms of stress urinary incontinence were found to be associated with total fat mass (OR 1.03, 95% CI: 1.01-1.06, P=0.017), trunk fat mass (OR 1.06, 95% CI: 1.02-1.11, P=0.009), android fat mass (OR 1.33, 95% CI: 1.05-1.70, P=0.020), visceral fat area (OR 1.01, 95% CI: 1.00-1.02, P=0.019), BMI (OR 1.07, 95% CI: 1.01-1.13, P=0.027), and waist circumference (OR 1.03, 95% CI: 1.01-1.05, P=0.008). No significant associations were found for other symptoms of pelvic floor disorders. Conclusions: Having a higher total or regional body fat mass, higher BMI, or larger waist circumference may increase the risk of stress urinary incontinence in middle-aged women.