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Randomized Controlled Trial
. 2009 Jan 29;360(5):481-90.
doi: 10.1056/NEJMoa0806375.

Weight loss to treat urinary incontinence in overweight and obese women

Leslee L Subak  1 , 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
Collaborators, Affiliations
Randomized Controlled Trial

Weight loss to treat urinary incontinence in overweight and obese women

Leslee L Subak et al. N Engl J Med. .

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.)

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Figures

Figure 1
Figure 1
Study Participants.
Figure 2
Figure 2
Proportion of Participants with Reductions in the Frequency of Any Incontinence Episode at 6 Months.
Figure 3
Figure 3
Proportion of Participants with Reductions in the Frequency of Episodes of Stress Incontinence and of Urge Incontinence at 6 Months.
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