Aims To determine whether a behavioral weight reduction intervention improves non-urinary incontinence (UI) lower urinary tract storage symptoms (LUTS) including urinary frequency, nocturia, urgency, at 6 months compared to a structured education program (control group) among overweight and obese women with UI. Methods The Program to Reduce Incontinence by Diet and Exercise (PRIDE) was a randomized clinical trial of 338 overweight or obese women with UI. Participants were randomized to 6-month behavioral weight loss intervention (N=226) or control (N=112). All participants received a self-help behavioral treatment booklet for improving bladder control. In this secondary data analysis, we examined changes in non-UI LUTS from baseline to 6 months and the impact of treatment allocation (intervention versus control), weight loss, and physical activity. Results Non-UI LUTS were common at baseline varying from 48 to 62 percent. For both groups combined, women experienced significant improvement in nocturia, urgency and International Prostate Symptom Score at 6 months (all P < 0.001). However, LUTS outcomes at 6 months did not differ between intervention and control group. Similarly, no differences were observed based on either the amount of weight lost (≥5% compared to <5%) or physical activity (≥ 1500 kilocalorie expenditure /week compared to < 1500 kilocalories). Conclusion LUTS were common among overweight and obese women with UI, with prevalence decreasing significantly after 6 months independent of treatment group assignment, amount of weight lost or physical activity. These improvements may be due to self-help behavioral educational materials, trial participation, or repeated assessment of symptoms.

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The extramural program at the University of the Pacific School of Dentistry is described. The program is designed to facilitate the students' transition from a school clinic to dental practice after graduation. Management skills are taught by providing supervised experience in a model practice setting. Five major facilities are described along with the curriculum modifications made to permit all students to spend eight four‐day weeks in these remote sites. The quality control mechanism is discussed as well as four key concepts developed in the six‐year experience of operating this program.

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