Urodynamic characterization of obese women with urinary incontinence undergoing a weight loss program: the Program to Reduce Incontinence by Diet and Exercise (PRIDE) trial
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The purpose of this study was to describe urodynamic characteristics of overweight or obese women with urinary incontinence and explore the relationship between urodynamic parameters, body mass index (BMI), and abdominal circumference (AC). One hundred ten women underwent a standardized cough stress test and urodynamic study. Eighty-six percent of women had urodynamic stress incontinence and 15% detrusor overactivity. Intra-abdominal pressure (Pabd) at maximum cystometric capacity (MCC) increased 0.4 cm H2O per kg/m2 unit of BMI (95% confidence interval [CI] = 0.0,0.7, p = 0.04) and 0.4 cm H2O per 2 cm increase in AC (CI = 0.2, 0.7, p < 0.01). Intravesical pressure (Pves) at MCC increased 0.4 cm H2O per 2 cm increase in AC (CI = 0.0, 0.8, p = 0.05) but was not associated with BMI (p = 0.18). BMI and AC had a stronger association with Pabd than with Pves, suggesting a possible mechanism for the association between obesity and urinary incontinence.
KeywordsMechanism Obesity Urinary incontinence Urodynamics Weight loss
The authors wish to acknowledge the contribution made by PRIDE investigators, staff, consultants, sponsors, and the Data and Safety Monitoring Board: The University of Alabama at Birmingham—Frank Franklin, M.D., Ph.D. (principal investigator), Holly Richter, Ph.D., M.D. (coinvestigator), Leslie Abdo, B.S.N., R.N., C.C.R.C., Charlotte Bragg, M.S., R.D., L.D., Kathryn Burgio, Ph.D. (coinvestigator), Kathy Carter, R.N., B.S.N., Juan Dunlap, Stacey Gilbert, M.P.H., Sara Hannum, Anne Hubbell, M.S., R.D., L.D., Karen Marshall, Lisa Pair, C.R.N.P., Penny Pierce, R.N., B.S.N., Clara Smith, M.S., R.D., Sue Thompson, R.N., Janet Turman, Audrey Wrenn, M.A.Ed.; The Miriam Hospital—Rena Wing, Ph.D. (principal investigator), Amy Gorin, Ph.D. (coinvestigator), Deborah Myers, M.D. (coinvestigator), Tammy Monk, M.S., Rheanna Ata, Megan Butryn, Ph.D., Pamela Coward, M.Ed., R.D., Linda Gay, M.S., R.D., C.D.E., Jacki Hecht, M.S.N., R.N., Anita Lepore-Ally, R.N., Heather Niemeier, Ph.D., Yael Nillni, Angela Pinto, Ph.D., Deborah Ranslow-Robles, Phlebotomist /Med. Asst., Natalie Robinson, M.S., R.D., Deborah Sepinwall, Ph.D., Margaret E. Hahn, M.S.N., R.N.P., Vivian W. Sung, M.D., M.P.H., Victoria Winn, Nicole Zobel; The University of Arkansas for Medical Sciences—Delia West, Ph.D. (investigator); The University of Pennsylvania—Gary Foster, Ph.D. (consultant); The University of California, San Francisco—Deborah Grady, M.D., M.P.H. (principal investigator), Leslee Subak, M.D. (co-principal investigator), Judith Macer, Ann Chang, Jennifer Creasman, M.S.P.H., Judy Quan, Ph.D., Eric Vittinghoff, Ph.D., Jennifer Yang. This study was supported by grants no. U01 DK067860, U01 DK067861, and U01 DK067862, partially supported by K24 DK068389, from The National Institute of Diabetes and Digestive and Kidney Diseases—John W. Kusek, Ph.D., Leroy M. Nyberg, M.D., Ph.D. (project officers).
Role of funding source
Investigator initiated research funded by the NIH. The project officers assisted in study design but did not perform collection, analysis, interpretation of data, or the writing of this report.
Data and Safety Monitoring Board
The University of Utah Health Sciences Center—Ingrid Nygaard, MD (DSMB chairperson); The Children’s Hospital Boston—Leslie Kalish, Sc.D.; The University of California, San Diego—Charles Nager, M.D.; The Medical University of South Carolina—Patrick M. O’Neil, Ph.D.; The Johns Hopkins School of Medicine—Cynthia S. Rand, Ph.D., The University of Virginia Health Systems—William D. Steers, M.D.
Conflicts of interest
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