Obesity is an established and modifiable risk factor for urinary incontinence, but conclusive evidence for a beneficial effect of weight loss on urinary incontinence is lacking. In a recently published study by Subak and colleagues [1], 338 overweight and obese women, with a mean age of 53 ± 11 years, and with at least ten urinary incontinence episodes per week, were randomly assigned to an intensive 6-month weight-loss program, including diet, exercise, and behavior modification (n = 226) or to a structured education program (n = 112). The body mass index and the weekly number of incontinence episodes were similar in the intervention group and the control group at baseline. The women in the intervention group had a mean weight loss of 8.0% (7.8 kg), as compared with 1.6% (1.5 kg) in the control group (p < 0.001). After 6 months, the mean weekly number of incontinence episodes decreased by 47% in the intervention group, compared with 28% in the control group (p = 0.01). The intervention group had a greater decrease in the frequency of stress incontinence episodes (p = 0.02), but not of urge incontinence episodes (p = 0.14) compared with the control group. A higher proportion of the intervention group than of the control group had a clinically relevant reduction of 70% or more in the frequency of all incontinence episodes (p < 0.001), stress incontinence episodes (p = 0.009), and urge incontinence episodes (p = 0.04). Thus the behavioral intervention targeting weight loss reduced the frequency of self-reported urinary incontinence episodes among overweight and obese women as compared with the control group. A decrease in urinary incontinence may be another benefit among the extensive health improvements associated with moderate weight reduction.
Author(s)
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Göran Samsioe
Lund, Sweden
Citations
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Subak LL, Wing R, West DS, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med 2009;360:481-90. Published January 29, 2009.
http://www.ncbi.nlm.nih.gov/pubmed/19179316 -
Monz B, Chartier-Kastler E, Hampel C, et al. Patient characteristics associated with quality of life in European women seeking treatment for urinary incontinence: results from PURE. Eur Urol 2007;51:1073-81.
http://www.ncbi.nlm.nih.gov/pubmed/17081676
