Weight loss to treat urinary incontinence in overweight and obese women
Leslee L Subak, Rena Wing, Delia Smith West, Frank Franklin, Eric Vittinghoff, Jennifer M Creasman, Holly E Richter, Deborah Myers, Kathryn L Burgio, Amy A Gorin, Judith Macer, John W Kusek, Deborah Grady, PRIDE Investigators, F Franklin, H E Richter, K L Burgio, L Abdo, C Bragg, K Carter, J Dunlap, S Gilbert, S Hannum, A Hubbell, K Marshall, L Pair, P Pierce, C Smith, S Thompson, J Turman, A Wrenn, R Wing, A Gorin, D Myers, T Monk, R Ata, M Butryn, P Coward, L Gay, J Hecht, A Lepore-Ally, H Niemeier, Y Nillni, A Pinto, D Ranslow-Robles, N Robinson, D Sepinwall, M E Hahn, V W Sung, V Winn, N Zobel, D West, G Foster, D Grady, L Subak, J Macer, A Chang, J Creasman, J Quan, E Vittinghoff, J Yang, J W Kusek, L M Nyberg, I Nygaard, L Kalish, C Nager, P M O'Neil, C S Rand, W D Steers, Leslee L Subak, Rena Wing, Delia Smith West, Frank Franklin, Eric Vittinghoff, Jennifer M Creasman, Holly E Richter, Deborah Myers, Kathryn L Burgio, Amy A Gorin, Judith Macer, John W Kusek, Deborah Grady, PRIDE Investigators, F Franklin, H E Richter, K L Burgio, L Abdo, C Bragg, K Carter, J Dunlap, S Gilbert, S Hannum, A Hubbell, K Marshall, L Pair, P Pierce, C Smith, S Thompson, J Turman, A Wrenn, R Wing, A Gorin, D Myers, T Monk, R Ata, M Butryn, P Coward, L Gay, J Hecht, A Lepore-Ally, H Niemeier, Y Nillni, A Pinto, D Ranslow-Robles, N Robinson, D Sepinwall, M E Hahn, V W Sung, V Winn, N Zobel, D West, G Foster, D Grady, L Subak, J Macer, A Chang, J Creasman, J Quan, E Vittinghoff, J Yang, J W Kusek, L M Nyberg, I Nygaard, L Kalish, C Nager, P M O'Neil, C S Rand, W D Steers
Abstract
Background: 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.
Methods: We randomly assigned 338 overweight and obese women with at least 10 urinary-incontinence episodes per week to an intensive 6-month weight-loss program that included diet, exercise, and behavior modification (226 patients) or to a structured education program (112 patients).
Results: The mean (+/-SD) age of the participants was 53+/-11 years. The body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) and the weekly number of incontinence episodes as recorded in a 7-day diary of voiding were similar in the intervention group and the control group at baseline (BMI, 36+/-6 and 36+/-5, respectively; incontinence episodes, 24+/-18 and 24+/-16, respectively). 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, as compared with 28% in the control group (P=0.01). As compared with the control group, 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). 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).
Conclusions: A 6-month behavioral intervention targeting weight loss reduced the frequency of self-reported urinary-incontinence episodes among overweight and obese women as compared with a control group. A decrease in urinary incontinence may be another benefit among the extensive health improvements associated with moderate weight reduction. (ClinicalTrials.gov number, NCT00091988.)
2009 Massachusetts Medical Society
Figures
Source: PubMed