A randomised controlled trial involved 48 overweight and obese women experiencing at least 4 urinary-incontinence (UI) episodes per week. Women were randomly assigned to a 3-month liquid diet weight reduction program or a wait-list delayed intervention group. Median (with 25% to 75% interquartile range [IQR]) baseline weight was 97 kg (IQR 87 to 106) and UI episodes were 21 weekly (IQR 11 to 33). Weight reduction was 16 kg (IQR 9 to 20) in the intervention group compared with 0 kg (IQR -2 to 2) in the control group (p <0.0001). The intervention group experienced a 60% reduction (IQR 30% to 89%) in weekly UI episodes compared with 15% (IQR -9% to 25%) in the control group (p <0.0005) and had greater improvement in quality of life scores. Stress (p =0.003) and urge (p =0.03) incontinent episodes decreased in the intervention vs control group. Following the weight reduction program the wait-list control group experienced a similar median reduction in weekly UI episodes (71%). Among all women mean weekly UI episodes decreased 54% (95% CI 40% to 69%) after weight reduction and the improvement was maintained for 6 months.
Another RCT involved 338 overweight and obese women with at least 10 UI episodes per week. Women were randomly assigned 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).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 self-reported mean weekly number of UI 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 UI episodes (P<0.001), stress-incontinence episodes (P=0.009), and urge-incontinence episodes (P=0.04).
The same group of overweight and obese women (n=338) were combined in another study to examine the effects of the magnitude of weight loss on changes in UI assessed by 7-day voiding diary, pad test, and self-reported satisfaction with change in UI. Compared with participants who gained weight (reference), those who lost 5 - 10% or 10% or more of their body weight had significantly greater percent reductions in UI episodes and were more likely to achieve at least a 70% reduction in the frequency of total and urge urinary incontinence episodes at 6, 12, and 18 months.
Date of latest search: 2012-01-25