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Weight loss with bariatric surgery or behaviour modification and the impact on female obesity‐related urine incontinence: A comprehensive systematic review and meta‐analysis
Author(s) -
Sheridan William,
Da Silva Ana Sofia,
Leca Bianca M,
Ostarijas Eduard,
Patel Ameet G,
Aylwin Simon JB,
Vincent Royce P,
Panagiotopoulos Spyros,
ElHasani Shamsi,
Roux Carel W,
Miras Alexander D,
Cardozo Linda,
Dimitriadis Georgios K
Publication year - 2021
Publication title -
clinical obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 12
eISSN - 1758-8111
pISSN - 1758-8103
DOI - 10.1111/cob.12450
Subject(s) - medicine , weight loss , urinary incontinence , obesity , meta analysis , quality of life (healthcare) , randomized controlled trial , psychological intervention , body mass index , systematic review , medline , physical therapy , weight loss surgery , incidence (geometry) , surgery , physics , nursing , optics , gastric bypass , political science , law , psychiatry
Summary Women with obesity are at risk of pelvic floor dysfunction with a 3‐fold increased incidence of urge urinary incontinence (UUI) and double the risk of stress urinary incontinence (SUI). The National Institute for Health and Care Excellence (NICE) and European Association of Urology (EAU) recommend that women with a body mass index ≥30 kg/m 2 should consider weight loss prior to consideration for incontinence surgery. This systematic review and meta‐analysis will assess this recommendation to aid in the counselling of women with obesity‐related urinary incontinence (UI). Medical Literature Analysis and Retrieval System online (MEDLINE), EMBASE, Cochrane, ClinicalTrials.gov, and SCOPUS were systematically and critically appraised for all peer reviewed manuscripts that suitably fulfilled the inclusion criteria established a priori and presented original, empirical data relevant to weight loss intervention in the management of urinary incontinence. Thirty‐three studies and their outcomes were meta‐analysed. Weight loss interventions were associated in a decreased prevalence in UI (OR 0.222, 95% CI [0.147, 0.336]), SUI (OR 0.354, 95% CI [0.256, 0.489]), UUI (OR 0.437, 95% CI [0.295, 0.649]) and improved quality of life (PFDI‐20, SMD ‐0.774 (95% CI [−1.236, −0.312]). This systematic review and meta‐analysis provide evidence that weight loss interventions are effective in reducing the prevalence of obesity‐related UI symptoms in women. Bariatric surgery in particular shows greater sustained weight loss and improvements in UI prevalence. Further large scale, randomized control trials assessing the effect of bariatric surgery on women with obesity‐related UI are needed to confirm this study's findings.