Obesity and Urinary Incontinence: Epidemiology and Clinical Research Update

Abstract

Purpose We reviewed the epidemiological literature on the association of obesity and urinary incontinence, and summarized clinical trial data on the effect of weight loss on urinary incontinence. Materials and Methods We systematically searched for published community based prevalence studies with bivariate or multivariate analysis of the association of urinary incontinence and overweight/obesity in women. Case series and randomized controlled trials of the effect of surgical, behavioral and pharmacological weight loss on urinary incontinence are summarized. Results Epidemiological studies showed that obesity is a strong independent risk factor for prevalent and incident urinary incontinence. There was a clear dose-response effect of weight on urinary incontinence with each 5-unit increase in body mass index associated with about a 20% to 70% increase in the urinary incontinence risk, and the maximum effect of weight rarely exceeded an OR of greater than 4 to 5 on well controlled analyses. The odds of incident urinary incontinence during 5 to 10 years increased by approximately 30% to 60% for each 5-unit increase in body mass index. There may be a stronger association of increasing weight with prevalent and incident stress incontinence, including mixed incontinence, than with urge incontinence and overactive bladder syndrome. Weight loss studies indicated that surgical and nonsurgical weight loss led to significant improvements in urinary incontinence symptoms. Conclusions Epidemiological studies document overweight and obesity as important risk factors for urinary incontinence. Weight loss by surgical and more conservative approaches is effective to decrease urinary incontinence symptoms and should be strongly considered a first line treatment in this patient population.

Novel insights into renal d-amino acid oxidase accumulation: propiverine changes DAAO localization and peroxisomal size in vivo

“…The International Continence Society defines symptoms of overactive bladder with urgency, urinary frequency, nocturia and urge incontinence (Wein 2011). Nowadays, increasing overweight and obesity are problematic since a positive correlation of weight and the extent of urinary incontinence has been reported (Subak et al 2009). Propiverine is one of six anticholinergics which are recommended by the Committee on Pharmacological Treatment for the treatment of OAB (Madersbacher and Mürtz 2001).…”

Caracterización clínica de la incontinencia urinaria y factores asociados en usuarias de la Unidad de la Mujer del Centro de Salud Familiar “Ultraestación” en la ciudad de Chillán, Chile

“…En el presente estudio se logró asociar significativamente a la obesidad con el desarrollo de IU, lo que concuerda con los estudios realizados en otros países 4,18,19 . También existe evidencia de que estrategias de reducción de peso se asocian a una reducción en los síntomas de IU 34 .…”

“…No existen estudios en Chile que demuestren la importancia de esta alteración en las usuarias de establecimientos de atención primaria. Igualmente, hay abundante evidencia internacional sobre factores de riesgo que se asocian al desarrollo o presencia de IU 3,5,15,16,17 , entre los que se encuentran la edad avanzada 3,5,6,16 , el aumento del índice de masa corporal 18,19,20,21 , la diabetes mellitus 22 , los embarazos y partos 23,24,25,26 , la historia de histerectomía 26,28,29,30 , y el inicio de la menopausia 26,27 . El presente estudio busca caracterizar la IU y los factores asociados a ésta en las mujeres que consultan en una unidad de la mujer en atención primaria, para determinar su peso relativo y así poder destinar recursos para su prevención y tratamiento.…”

Incontinência urinária de esforço em mulheres pertencentes ao Programa de Saúde da Família de Dourados (MS)

“…Studies that do not evaluate the types of UI separately show strong association with obesity. 38,39 A randomized study showed that weight loss is associated with decrease in the prevalence of UI. 40 A study conducted in the state of Washington, USA, interviewed women between 30 and 90 years and showed that the variable BMI > 30 kg m 2 doubled the risk of developing UI.…”