P2478 - Sarcopenia Is a Risk Factor for Pelvic Organ Prolapse Independent of Age

Vipul Sheth, MD, PhD, Laren Becker, MD, PhD, Tie Liang, , Brooke Gurland, MD, Lelia Neshatian, MD, MSc
Stanford University, Redwood City, CA

Introduction: The pathophysiology of pelvic floor laxity and pelvic organ prolapse are largely unknown. Aging is one of the strongest risk factors for the decline in the pelvic floor function. Aging is associated with a gradual loss of muscle mass, known as sarcopenia. We hypothesize that reduced muscle mass on MRI defecography (MRD) is associated with decline in pelvic floor function and predisposes women to a more severe clinical prolapse presentation. We aimed to compare the muscle mass composition and volume among patients with or without pelvic organ prolapse.

Methods: Review of 88 MRDs showed psoas FF significantly elevated in patients with abnormal resting and strain H and M lines (p< 0.05). Moreover, psoas FF was significantly higher in women with rising grades of Oxford rectal prolapse (p=0.0001), uterovaginal descent (p=0.001) and bladder descent (p=0.0005). Puborectalis FF was significantly increased by rising grades of oxford rectal prolapse (p=0.0002). In multivariate analysis, adjusted for age and BMI, psoas FF was an independent risk factor for abnormal strain H line (p< 0.01) and M line (0.03). It was also an independent risk factor for rising Oxford grade of rectal prolapse (p< 0.01) and bladder descent (p=0.02). Neither of psoas or puborectalis CSA/M² were associated with increased pelvic floor laxity measures.

Results: Review of 88 MRDs showed psoas FF significantly elevated in patients with abnormal resting and strain H and M lines (p< 0.05). Moreover, psoas FF was significantly higher in women with rising grades of Oxford rectal prolapse (p=0.0001), uterovaginal descent (p=0.001) and bladder descent (p=0.0005). Puborectalis FF was significantly increased by rising grades of oxford rectal prolapse (p=0.0002). In multivariate regression analysis when adjusted for age and BMI, psoas FF was an independent risk factor for abnormal strain H and M lines with p< 0.01 and 0.03 respectively. It was also an independent risk factor for rising Oxford grade of rectal prolapse (p< 0.01) and bladder descent (p=0.02). Neither of psoas or puborectalis CSA/M² were associated with increased pelvic floor laxity measures.

Discussion: Reduced muscle mass on MRD is a risk factor of pelvic floor laxity, independent of aging. Moreover, the severity of pelvic organ prolapse appears to be associated with deteriorating muscle mass in patients of all ages. Future prospective research is needed to determine if sarcopenia may predict postsurgical outcomes after pelvic organ prolapse repair.



Disclosures:


Vipul Sheth, MD, PhD, Laren Becker, MD, PhD, Tie Liang, , Brooke Gurland, MD, Lelia Neshatian, MD, MSc. P2478 - Sarcopenia Is a Risk Factor for Pelvic Organ Prolapse Independent of Age, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.