Monday, 4 November 2013

Obesity and Urinary Incontinence

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. Urinary Incontinence
Urinary incontinence is defined as a condition of
involuntary leakage of urine when under stress late stage of pregnancy, obesity, etc.

C. How to calculate your BMI index

BMI= weight (kg)/ height ( m2)

D. How Obesity associated with Urinary Incontinence
1. According to the study of "Risk Factors for the Development of Stress Urinary Incontinence in Women" by Stothers L, Friedman B. (Source from University of British Columbia, Vancouver, British Columbia, V5Z 1M9, Canada,, Curr Urol Rep. 2011 Sep 22. [Epub ahead of print]). posted in PubMed, researchers indicated that Obesity is an increasingly prevalent health condition that was shown to have detrimental impact on SUI (Stress urinary incontinence) development, while weight reduction was proven to reduce SUI.

2. According to the research of "Obesity and smoking: Are they modulators of cough intravesical peak pressure in stress urinary incontinence?" by Fuganti PE, Gowdy JM, Santiago NC. (Source from Hospital de Câncer de Londrina, Parana, Brazil. Int Braz J Urol. 2011 Jul-Aug;37(4):528-33.), posted in PubMed, researchers found that Obesity and smoking showed increased CIPP (maximal Intravesical Peak Pressures generated by Cough). While reduced BMI is related to lower CIPP, smoking cessation does not appear to diminish CIPP. These findings suggest that weight loss may reduce incontinence by CIPP modulation. However, the benefits of smoking cessation without additional lifestyle modification, may have no benefit to improve urinary incontinence.

3. In a study of "Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008", by Markland AD, Richter HE, Fwu CW, Eggers P, Kusek JW (Source from Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, University of Alabama at Birmingham, Birmingham, Alabama, Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.35249-7333, USA), post in PubMed, researchers found that The age standardized prevalence of urinary incontinence increased in men and women from 2001 through 2008. Decreasing obesity and diabetes may lessen the burden of urinary incontinence, especially in women.

4. In the abstract of the stuyd of "The prevalence of urinary incontinence and its burden on the quality of life among older adults with medicare supplement insurance" by Hawkins K, Pernarelli J, Ozminkowski RJ, Bai M, Gaston SJ, Hommer C, Migliori RJ, Yeh CS. (Source from Health Care Innovation and Information, Ingenix, 5430 Data Court, Ann Arbor, MI 48108, USA., Qual Life Res. 2011 Jun;20(5):723-32. Epub 2010 Dec 8.), posted in PubMed, researchers indicated that Of the 5,530 eligible respondents, 37.5% reported having UI. The strongest predictors of UI were female gender, advancing age, and obesity. All the QOL estimates were significantly lower for those with UI (P < 0.001). Further, UI had a stronger influence on QOL than did diabetes, cancer, and arthritis, particularly from a mental health standpoint.


E. Treatments of Obesity and Urinary continence
1. According to the study of "Obesity and weight management in the elderly" by Han TS, Tajar A, Lean ME. (Source from Department of Diabetes and Endocrinology, Ashford and St Peter’s NHS Trust, Chertsey, Surrey, UK., Br Med Bull. 2011;97:169-96. Epub 2011 Feb 16.), posted in PubMed, researchers found that A large number of clinical consequences of overweight and obesity are particularly problematic for elderly individuals, including type 2 diabetes mellitus, arthritis, urinary incontinence and depression. Obesity, and specifically sarcopenic obesity, should also be prevented not only from younger age, but also during major life transitions including retirement, to improve better health outcomes and quality of life in later years, with a focus on those in 'obese families', where the main increases in obesity are located. Randomized controlled trials to determine health benefits and risks from long-term weight management in obese elderly are necessary.

2. In an abstract of the study of `[Sub-urethral sling in the treatment of female urinary incontinence: which? how?]` [Article in French] by Debodinance P, Hermieu JF. (Source Service de Gynécologie-Obstétrique, GCS Flandre-Maritime, avenue de la Polyclinique, 59760 Grande-Synthe, France., Gynecol Obstet Fertil. 2010 Oct;38(10):607-19. Epub 2010 Sep 28.), posted in PubMed, researchers stated that Without adequate clinical trials proving their efficacy and safety, the mini-bands can so far be recommended to treat female stress urinary incontinence. Moderate overweight does not affect the results of laying tape. In patients with severe obesity, surgery to correct obesity is even better than surgery for incontinence. Age is not a contra-indication. If the patient is young and nulliparous,...

3. In a study of `Effect of weight loss on urinary incontinence in overweight and obese women: results at 12 and 18 months`by Wing RR, West DS, Grady D, Creasman JM, Richter HE, Myers D, Burgio KL, Franklin F, Gorin AA, Vittinghoff E, Macer J, Kusek JW, Subak LL; Program to Reduce Incontinence by Diet and Exercise Group. (Source from The Miriam Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island 02903, USA., 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved), posted in PubMed, researchers concluded that Weight loss intervention reduced the frequency of stress incontinence episodes through 12 months and improved patient satisfaction with changes in incontinence through 18 months. Improving weight loss maintenance may provide longer term benefits for urinary incontinence.

4. According to the study of `Improving urinary incontinence in overweight and obese women through modest weight loss`by Wing RR, Creasman JM, West DS, Richter HE, Myers D, Burgio KL, Franklin F, Gorin AA, Vittinghoff E, Macer J, Kusek JW, Subak LL; Program to Reduce Incontinence by Diet and Exercise. ( Source from Miriam Hospital, Providence, Rhode Island 02903, USA.), posted in PubMed, researchers found that Weight losses between 5% and 10% of body weight were sufficient for significant urinary incontinence benefits. Thus, weight loss should be considered as initial treatment for incontinence in overweight and obese women.

5. Etc.

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