Moderate weight loss in obese women with urinary incontinence: a prospective longitudinal study

Abstract

This study assessed the effect of moderate weight loss in obese women with urodynamically proven urinary incontinence using the International Consultation on Incontinence recommended outcome measures. Sixty-four incontinent women were offered a weight reduction programme with a target loss of 5-10%. This included a low-calorie diet and exercise. An anti-obesity drug (Orlistat) was offered to those who failed to achieve their target. Forty-two (65%) achieved the target weight loss and had significant reduction in body mass index and girth. Weight loss was associated with significant reduction in pad test loss (median difference, 19 g; 95% confidence interval, 13-28 g; p < 0.001). There was also a clinical and statistically significant improvement in quality of life measures. These results suggest that weight reduction of 5% of initial body weight can improve urinary incontinence severity and its effects on quality of life in obese women.

Efeitos da cirurgia bariátrica na função do assoalho pélvico

“…In this research, the pelvic floor muscle strength, measured by the modified Oxford scale, increased significantly one year after bariatric surgery compared to the preoperative period. Auwad et al found similar results in their study group, patients who achieved weight loss ≥ 5% of body weight showed significant increase in pelvic floor muscle strength measured by the Oxford Scale, along with improvement in urinary leakage 1 . In this study, the quality of the muscle contraction of the pelvic floor through perineometry, as well as in the modified Oxford Scale, showed a significant increase in mean peak contraction of the pelvic floor postoperatively compared to the preoperative period.…”

“…In obese, studies show that after massive, surgically induced weight loss, there is resolution or alleviation of the symptoms of urinary incontinence 14,15,20,22,26,27 . Urinary incontinence usually leads to withdrawal from social interaction, psychosocial frustrations and early institutionalization.2 Therefore, its diagnosis and treatment are particularly important in women with morbid obesity, contributing to the improvement of quality of life 1,13,17,20,26,27 . The aim of this study is to analyze the effects of weight loss induced by bariatric surgery on pelvic floor function.…”

Qual o índice de massa corporal de mulheres com disfunções dos músculos do assoalho pélvico que procuram tratamento fisioterapêutico?

“…Estudos demonstram que a redução do peso leva a significante diminuição dos episódios de IU, da noctúria, melhora na qualidade de vida e decréscimo da pressão intravesical 11 11,[33][34][35] suportam a perda de peso como opção de tratamento para mulheres com sobrepeso ou obesas e incontinentes, pois a redução dos episó-dios semanais de IU de 50 a 60% com a perda de peso é comparável com a melhora observada em estudos com terapias comportamentais e com terapias farmacológi-cas 35 . Porém, Kudish et al 7 observaram que a redução de peso não parece estar associada à regressão significativa do prolapso de órgãos pélvicos, sugerindo que o dano no assoalho pélvico, relacionado ao ganho de peso, pode demorar mais tempo para regredir ou ser irreversível.…”

“…Recentemente, a identificação do excesso de peso e da obesidade é sugerida como parte integrante dos programas de reabilitação do AP 8 . Assim, a redução de peso tem sido incluída no tratamento da incontinência urinária (IU) e do prolapso genital 9,10 , uma vez que a redução de 5% do peso corporal contribui para redução da severidade da IU 11 . Ambas as condições, obesidade e disfunções do AP, impactam negativamente na qualidade de vida das mulheres que as apresentam 12 .…”

Obesity and smoking: Are they modulators of cough intravesical peak pressure in stress urinary incontinence?

“…Current smokers and former smokObesity and smoking: CIPP modulators in SUI CIPP increases with BMI and that BMI is also an independent predictor for CIPP. Some studies have already shown the beneficial effects of weight loss on SUI (4,10,11). Nevertheless, one cannot predict the degree of improvement of SUI when treating obesity.…”