Obesity and Stress Urinary Incontinence: Impact on Pathophysiology and Treatment

Abstract

Purpose of Review

Obesity is highly prevalent and is associated with stress urinary incontinence (SUI). The purposes of this review are to assess the pathophysiology of SUI in the obese female and review the outcomes of weight loss and anti-incontinence surgery in this population.

Recent Findings

While increased intra-abdominal pressure appears to be the common pathophysiologic link between obesity and SUI, neurogenic and metabolic pathways have been proposed. Both surgical and non-surgical weight loss continue to have beneficial effects on SUI; however, long-term outcomes are largely absent. Midurethral sling (MUS) surgery is largely effective in the obese population, with a complication profile similar to that in non-obese women. Obesity has been shown to be a risk factor for failure of MUS.

Summary

While weight loss should be the primary modality to improve SUI in the obese woman, MUS remains an effective and safe option in those women undertaking surgery.

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References

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Alex Fuselier, Jordan Hanberry, J. Margaret Lovin, and Alex Gomelsky each declare no potential conflicts of interest.

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Fuselier, A., Hanberry, J., Margaret Lovin, J. et al. Obesity and Stress Urinary Incontinence: Impact on Pathophysiology and Treatment. Curr Urol Rep 19, 10 (2018). https://doi.org/10.1007/s11934-018-0762-7

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Keywords

  • Stress urinary incontinence
  • Obesity
  • Weight loss
  • Surgery
  • Complications