The role of obesity on urinary incontinence and anal incontinence in women: a review

Doumouchtsis, Stergios K.; Loganathan, Jemina; Pergialiotis, Vasilios

doi:10.1111/1471-0528.16848

Cited by 27 publications

(22 citation statements)

References 74 publications

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“…As expected, our study found that in the case of UI, a strong association existed between advanced age, postmenopausal status, and obesity, which has been reported previously [ 6 – 8 , 10 , 11 ]. Obesity leads to a continuous increase in intra-abdominal pressure, which may result in weakness of the pelvic floor muscles and a subsequent elevated risk of UI [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

A population-based cross-sectional survey on the prevalence, severity, risk factors, and self-perception of female urinary incontinence in rural Fujian, China

Wang¹,

Yan-zhen

Yang³

et al. 2023

Int Urogynecol J

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Introduction and hypothesis To determine the prevalence, severity, risk factors and self-perception of female urinary incontinence (UI) in rural Fujian, China. Methods This population-based cross-sectional study was conducted between June and October 2022. Women aged 20 to 70 years from rural communities in Fujian Province were selected by multistage random sampling. Data from respondents were collected by completing standardised questionnaires through face-to-face interviews. The main outcome was prevalence and self-perception of UI. Results A total of 5659 valid questionnaires were collected. The overall prevalence of female UI was 23.6% (95% CI 22.5–24.7). The most common type was stress UI with a prevalence of 14.0% (95% CI 13.1–14.9), followed by mixed UI with a prevalence of 6.1% (95% CI 5.5–6.7), and finally urgency UI with a prevalence of 3.5% (95% CI 3.0–3.9). Multivariate regression analysis suggested that older age, obesity, postmenopausal status, multiple vaginal deliveries, macrosomia, instrumental vaginal delivery and previous pelvic floor surgeries were independently associated with UI ( P < 0.05). The overall awareness rate of UI was 24.7%, and older age, lower level of education, and income were significantly associated with a decrease in awareness ( P < 0.05). Only 33.3% of respondents believed they should seek medical help for UI. Conclusion UI affects more than one-fifth of women in rural Fujian, and several factors are thought to be associated with its development. Rural women have a poor self-perception of UI, which is exacerbated by older age, lower levels of education, and lower income.

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Section: Discussionmentioning

confidence: 99%

A population-based cross-sectional survey on the prevalence, severity, risk factors, and self-perception of female urinary incontinence in rural Fujian, China

Wang¹,

Yan-zhen

Yang³

et al. 2023

Int Urogynecol J

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“…In the present study, BMI was found as another associated risk factor for CI, in line with studies which also have shown this relationship ( 8 – 10 , 22 ). Indeed, obesity is a known risk factor for UI, and the pathophysiological mechanism has been explained by the negative effects of chronic increased intra-abdominal pressure and oxidative stress from visceral adipose on the collagen content and supportive neuromuscular structures of the pelvic floor ( 27 ). However, there are also studies reporting no association ( 2 , 4 ).…”

Section: Discussionmentioning

confidence: 99%

The association of coital incontinence with clinical factors and single voiding cycle ambulatory urodynamic monitoring findings in women

Çetinkaya

Seval²,

Varlı³

et al. 2023

Front. Med.

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IntroductionCoital incontinence (CI) is a frequent problem in women with urinary incontinence (UI) with significant impact on female sexuality and quality of life. The underlying mechanism is controversial; it has been known that CI is associated with both stress urinary incontinence (SUI) and detrusor overactivity (DO). However, recently it has been reported that CI is mainly related with SUI and urethral incompetence, but not with DO. Ambulatory urodynamic monitoring (AUM) has been shown to be a sensitive tool for the detection of DO. The aim of this study was to investigate the clinical risk factors for CI and the association of CI with urodynamic diagnoses at single voiding cycle AUM.MethodsRecords of sexually active women with urinary incontinence attending the urogynaecology unit of a university hospital, who completed the PISQ-12 were reviewed retrospectively (n = 1,005). Patients were grouped using the 6th question; patients answering “never” to this question were considered as continent during coitus (n = 591) and patients reporting any urinary leakage at coitus were considered to have CI (n = 414). Demographics, clinical examination findings, incontinence severity measured by the Sandvik Incontinence Severity Index, scores of Turkish validated questionnaires (PFDI-20, IIQ-7, OAB-V8, and PISQ-12) and single voiding cycle AUM findings were compared, and univariate and multivariate logistic regression analyses were performed.ResultsAmong all sexually active women with UI, 41.2% had CI; UI was more severe, symptom bother was higher, related quality of life (p < 0.001) and sexual function were worse (≤0.018) in these women. Younger age (OR 0.967, p < 0.001), history of vaginal delivery (OR 2.127, p = 0.019), smoking (OR 1.490, p = 0.041), postural UI (OR 2.012, p = 0.001), positive cough stress test (OR 2.193, p < 0.001), and positive SEST (OR 1.756, p = 0.01) were found as independent clinical factors associated with CI. Urodynamic SUI (OR 2.168, p = 0.001) and MUI (OR 1.874, p = 0.002) were found as significant and independent urodynamic diagnoses associated with CI, whereas no association was found with DO or UUI.ConclusionBoth clinical and AUM findings supported that CI is a more severe form of UI that it is mainly related with SUI and urethral incompetence, but not with UUI or DO.

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“…Body mass index has been linked to intra-abdominal pressure and intravesical pressure, which overcomes urethral closing pressure and leads to incontinence [ 44 ]. In addition, oxidative stress from visceral adipose tissue is likely to have a negative effect on the collagen and supportive structures of the pelvic floor, which confer continence [ 45 ]. Our meta-analysis indicates that these three factors are associated with UI among CrossFit practitioners.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of urinary incontinence in female CrossFit athletes: a systematic review with meta-analysis

et al. 2022

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Introduction and hypothesis Studies on the prevalence of urinary incontinence (UI) among CrossFit practitioners are on the rise. This systematic review with meta-analysis was aimed at determining the prevalence of UI among CrossFit practitioners. Methods A systematic review of the literature was performed by searching MEDLINE/PubMed, Scopus, and SPORTDiscus through January 2021. The search strategy included the keywords CrossFit, urine incontinence, exercise, high impact and pelvic floor dysfunction. The inclusion criterion was any study with a sample of CrossFit practitioners and results separated from the other fitness modalities analysed. The subjects were women with no restriction of age, parity, experience or frequency of training. Quality assessment of the studies included was conducted using the Oxford Centre of Evidence-Based Medicine scale and the Newcastle–Ottawa Scale (NOS) adapted for cross-sectional studies. Results Thirteen studies (6 comparative and 7 non-comparative) were included for the systematic review, all using a cross-sectional design. The level of evidence was 4, with their quality ranging from poor ( n = 10) to fair ( n = 3). A total of 4,823 women aged 18 to 71 were included, 91.0% participated in CrossFit, and 1,637 presented UI, which indicates a prevalence of 44.5%. Also, 55.3% and 40.7% presented mild or moderate UI respectively. Stress UI was the most common type reported (81.2%). Conclusions The factors that increased the likelihood of UI were age, body mass index and parity. Exercises based on jumps were commonly associated with urine leakage. CrossFit practitioners presented higher UI than control groups.

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The role of obesity on urinary incontinence and anal incontinence in women: a review

Cited by 27 publications

References 74 publications

A population-based cross-sectional survey on the prevalence, severity, risk factors, and self-perception of female urinary incontinence in rural Fujian, China

A population-based cross-sectional survey on the prevalence, severity, risk factors, and self-perception of female urinary incontinence in rural Fujian, China

The association of coital incontinence with clinical factors and single voiding cycle ambulatory urodynamic monitoring findings in women

Prevalence of urinary incontinence in female CrossFit athletes: a systematic review with meta-analysis

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