BERKELEY, CA (UroToday.com) - Most studies examining the relationship between obesity and urinary symptoms have focused on urinary incontinence in women or composite scores of urinary symptoms suggestive of benign prostatic hyperplasia in men. Use of composite indices may obscure associations with specific urinary symptoms. The FINNO study used symptom-specific questions to measure the association of individual urinary storage symptoms with obesity in a population-based sample of men and women across a wide age range.
Mailed questionnaires were sent to 6 000 adults randomly selected from the Finnish Population Register. Validated urinary symptom questionnaires were used to query storage-symptom prevalence and severity. Height and weight were self reported and used to calculate body mass index (BMI). Confounder scores were calculated based on numerous comorbid conditions and medications. Potential confounders also included sociodemographic, lifestyle, and reproductive factors. Odds ratios for the association between obesity (defined as a BMI > 30 kg/m2) and each individual storage symptom were calculated using multivariate logistic regression.
The results of the FINNO study revealed that obesity was associated with doubled risk of stress urinary incontinence (SUI) and tripled risk of urgency urinary incontinence (UUI) in women (too few men reported SUI and UUI), but obesity was not associated with urgency in either gender. Additionally, obesity was associated with doubled risk of nocturia in both men and women. Generally there were few differences between the genders; however, obese men were more likely to report urinary frequency than obese women, after multivariate adjustment. Also, other significant associations were found in the age-adjusted analyses, but relationships did not persist after adjustment for confounding factors, highlighting the importance for assessment of potential confounding factors. The cross-sectional study design precludes conclusions about causality, and longitudinal studies are needed to further describe the relationship between obesity and individual urinary storage symptoms.
In the population-based FINNO Study obesity doubled the odds of SUI and tripled the odds of UUI among women. In addition, obese men were twice as likely to report urinary frequency, while BMI was not associated with urinary frequency in women. Finally, obese men and women had twice the prevalence of nocturia compared to normal weight individuals, but being overweight or obese was not associated with urinary urgency after careful adjustment for confounders.
Overall, these results add to a strong body of evidence regarding the negative outcomes of increased body weight and urinary storage symptoms. The symptom-specific results in this analysis suggest differential impact of obesity on individual urinary storage symptoms, which may be influenced by gender.
Camille P. Vaughan, MD, MSca and Kari A.O. Tikkinen, MD, PhDb as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
- Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, and Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, Georgia
- Department of Clinical Epidemiology & Biostatistics, McMaster University, 1200 Main St. West, Room 2C21, Hamilton, Ontario, Canada L8S 4L8