Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women

Subak, Leslee L.; Wing, Rena R.; West, Delia Smith; Franklin, Frank A.; Vittinghoff, Eric; Creasman, Jennifer M.; Richter, Holly E.; Myers, Deborah L.; Burgio, Kathryn L.; Gorin, Amy A.; Macer, Judith L.; Kusek, John W.; Grady, Deborah

doi:10.1056/nejmoa0806375

Cited by 543 publications

(343 citation statements)

References 36 publications

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“…29 In our study, the increase in total testosterone was correlated with the magnitude of weight loss and reduction in WC, possibly because of reduced insulin resistance; 5,30 moreover, aromatase activity in adipose tissue results in increased estradiol production, decreased pituitary gonadotropin production and reduction in testicular synthesis of testosterone. 31 In obese women, urinary symptoms and incontinence are improved by weight loss, 32 but there is a paucity of similar data in men. To our knowledge, these are the first data to show that diet-induced weight loss ameliorates LUTS in obese men with undiagnosed urinary tract dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…The International Prostate Symptom Scale (IPSS) is a series of questions used to assess the severity of irritative (frequency, urgency, nocturia) and obstructive LUTSs (incomplete emptying, intermittency, weak stream, straining), attributable to bladder outlet obstruction caused by prostatic enlargement. 19 Symptoms are classified as mild (score 0-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) or severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).…”

Section: Questionnairesmentioning

confidence: 99%

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Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men

et al. 2010

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Objective: Abdominal obesity and type 2 diabetes mellitus are associated with erectile and urinary dysfunction in men. The extent to which sexual function and lower urinary tract symptoms (LUTSs) are improved by weight loss remains unclear. Subjects: We compared the effects of 8 weeks of a low-calorie diet using meal replacements (Kicstart) on insulin sensitivity, plasma testosterone levels, erectile function (measured by the five-item version of the International Index of Erectile Function, IIEF-5), sexual desire (measured by the Sexual Desire Inventory, SDI) and LUTS (measured by the International Prostate Symptom Score, IPSS), in abdominally obese (body mass index X30 kg m À2 , waist circumference (WC) X102 cm) men (mean age 49.7 years) with uncomplicated diet or oral hypoglycemic-treated type 2 diabetes mellitus (n ¼ 19) or without type 2 diabetes mellitus (n ¼ 25), with a control group of nondiabetic men (n ¼ 26) with similar body mass index and WC. Results: Weight loss of B10% was significantly associated with increased insulin sensitivity, plasma testosterone levels, IIEF-5 and SDI scores, as well as reduced WC and IPSS scores, in diabetic as well as nondiabetic men. The degree of weight loss was significantly associated with improvements in plasma testosterone levels (r ¼ À0.34), erectile function (r ¼ À0.26) and LUTS (r ¼ 0.65). Reduction in LUTS was significantly associated with increased plasma testosterone (r ¼ À0.35), erectile function (r ¼ À0.42) and sexual desire (r ¼ À0.40). Conclusions: Diet-induced weight loss significantly and rapidly improves sexual function, and reduces LUTS, in obese middleaged men with or without diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Questionnairesmentioning

confidence: 99%

Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men

et al. 2010

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“…Three new RCTs were added; all report significant improvement in UI associated with weight loss. [4][5][6] Massive weight loss (15 to 20 BMI points) decreases UI in morbid obesity (Level of Evidence: 2). Moderate weight loss is effective in decreasing UI if combined with exercise.…”

Section: Urinary Incontinence (1a) Lifestyle Interventionsmentioning

confidence: 99%

Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: Summary of the 5th International Consultation on Incontinence

Dumoulin

Hunter

Moore

et al. 2014

Neurourology and Urodynamics

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AimsThe objective of the 5th International Consultation on Incontinence (ICI) chapter on Adult Conservative Management was to review and summarize the new evidence on conservative management of urinary incontinence (UI) and pelvic organ prolapse (POP) in order to compile a current reference source for clinicians, health researchers, and service planners. In this paper, we present the review highlights and new evidence on female conservative management. MethodsRevision and updates of the 4th ICI Report using systematic review covering years 2008-2012. ResultsEach section begins with a brief definition and description of the intervention followed by a summary, where possible, of both the state and level of evidence for prevention and treatment, and ends with a "grade of recommendation." The paper concludes with areas identified as requiring further research. ConclusionsFor UI, there are no prevention trials on lifestyle interventions. There are, however, few new intervention trials of lifestyle interventions involving weight loss and fluid intake with improved levels of evidence and grade of recommendation. Outside of pre-and post-natal pelvic floor muscle training (PFMT) trials for the prevention of female UI, there is a dearth of PFMT prevention trials for women with UI. PFMT remains the first-line treatment for female UI with high levels of evidence and grades of recommendation. Bladder training levels of evidence and grades of recommendation are maintained. For POP, new evidence supports the effectiveness of physiotherapy in the treatment of POP and there are now improved levels of evidence and grades of recommendation. Neurourol. Urodynam. 35:15-20, 2016.

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“…A large randomized trial of overweight and obese women with urinary incontinence symptoms underwent an intensive 6 month weight loss program compared to a group with a structured education program. (Subak et al, 2009) Mean weight loss was 8 percent (7.8 kg) and 1.6 percent (1.5 kg) in the intervention and control groups, respectively. The authors found that weekly incontinence episodes decreased by 47 percent in the intervention group compared to only 28 percent in the control group.…”

Section: Dietary and Lifestyle Modificationmentioning

confidence: 88%

Diagnosis and Treatment of Overactive Bladder

2013

Female Pelvic Medicine &Amp; Reconstructive Surgery

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Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women

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.

Cited by 543 publications

References 36 publications

Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men

Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men

Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: Summary of the 5th International Consultation on Incontinence

Diagnosis and Treatment of Overactive Bladder

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