To determine whether a behavioral weight reduction intervention improves non-urinary incontinence (UI) lower urinary tract storage symptoms (LUTS) including urinary frequency, nocturia, urgency, at 6 months compared to a structured education program (control group) among overweight and obese women with UI.
The Program to Reduce Incontinence by Diet and Exercise (PRIDE) was a randomized clinical trial of 338 overweight or obese women with UI. Participants were randomized to 6-month behavioral weight loss intervention (N=226) or control (N=112). All participants received a self-help behavioral treatment booklet for improving bladder control. In this secondary data analysis, we examined changes in non-UI LUTS from baseline to 6 months and the impact of treatment allocation (intervention versus control), weight loss, and physical activity.
Non-UI LUTS were common at baseline varying from 48 to 62 percent. For both groups combined, women experienced significant improvement in nocturia, urgency and International Prostate Symptom Score at 6 months (all P < 0.001). However, LUTS outcomes at 6 months did not differ between intervention and control group. Similarly, no differences were observed based on either the amount of weight lost (>5% compared to <5%) or physical activity (> 1500 kilocalorie expenditure /week compared to < 1500 kilocalories).
LUTS were common among overweight and obese women with UI, with prevalence decreasing significantly after 6 months independent of treatment group assignment, amount of weight lost or physical activity. These improvements may be due to self-help behavioral educational materials, trial participation, or repeated assessment of symptoms.
The Journal of urology. 2017 Aug 11 [Epub ahead of print]
Benjamin N Breyer, Jennifer M Creasman, Holly E Richter, Deborah Myers, Kathryn L Burgio, Rena R Wing, Delia Smith West, John W Kusek, Leslee L Subak, Program to Reduce Incontinence by Diet and Exercise (PRIDE)
University of California San Francisco, Departments of Urology and Epidemiology & Biostatistics, San Francisco, California. Electronic address: ., University of California San Francisco, Departments of Obstetrics, Gynecology & Reproductive Sciences, UCSF Women's Health Clinical Research Center, San Francisco, California., University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Birmingham, AL., Warren Alpert Medical School at Brown University, Department of Obstetrics & Gynecology, Providence, RI., University of Alabama at Birmingham, Department of Medicine, Birmingham, AL; Department of Veterans Affairs, Birmingham, AL., The Miriam Hospital, Providence RI; Warren Alpert Medical School at Brown University, Department of Psychiatry and Human Behavior, Providence, RI., Arnold School of Public Health, Department of Exercise Science University of South Carolina, Columbia, SC., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD., University of California San Francisco, Departments of Obstetrics, Gynecology & Reproductive Sciences, Urology, and Epidemiology & Biostatistics, San Francisco, California; Department of Veterans Affairs, San Francisco, CA.