American urogynecologic society systematic review: The impact of weight loss intervention on lower urinary tract symptoms and urinary incontinence in overweight and obese women

Tajnoos Yazdany, Sharon Jakus-Waldman, Peter C. Jeppson, Megan O. Schimpf, Ladin A. Yurteri-Kaplan, Tanaz R. Ferzandi, Emily Weber-Lebrun, Leise Knoepp, Mamta Mamik, Meera Viswanathan, Renée M. Ward

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Objective Obesity can contribute to urinary symptoms such as urgency, frequency, and incontinence. In addition to classic treatments, weight loss interventions offer a unique clinical opportunity to improve these symptoms. Study Design The American Urogynecologic Society Systematic Review Group conducted a review of articles on the impact of surgical and behavioral weight loss (BWL) interventions on urinary symptoms in overweight and obese women. The certainty of the evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation criteria. Results The review group identified 43 publications from 39 studies, including 10 reports that used data from 5 randomized trials. Overall, there is high-certainty evidence that BWL, such as diet and exercise, decreases the prevalence of stress urinary incontinence 15% to 18% and overall urinary incontinence (UI) by 12% to 17% at 1 to 2.9 years. The certainty of evidence on the long-term impact of these interventions was lower. The certainty of the evidence was moderate to low regarding the benefit of BWL on urgency UI and overactive bladder symptoms. No randomized trials evaluated the impact of surgical weight loss on urinary symptoms, and the certainty of evidence of other study types was very low. Conclusions There is high-certainty evidence that BWL results in modest improvements in stress and overall UI in overweight and obese women at 1 to 2.9 years after the intervention. Robust studies with low risk of bias are needed to assess whether these benefits are maintained over the long term and are associated with adverse events and to assess the impact of surgical weight loss interventions on urinary outcomes in overweight and obese women.

Original languageEnglish
Pages (from-to)16-29
Number of pages14
JournalFemale Pelvic Medicine and Reconstructive Surgery
Volume26
Issue number1
DOIs
StatePublished - 1 Jan 2020

Keywords

  • lower urinary tract symptoms
  • obesity
  • overactive bladder
  • urinary incontinence
  • weight loss interventions

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