Benjamin N Breyer1, Jennifer M Creasman2, Holly E Richter3, Deborah Myers4, Kathryn L Burgio5, Rena R Wing6, Delia Smith West7, John W Kusek8, Leslee L Subak9. 1. Departments of Urology and Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California; Department of Urology, University of California-San Francisco, San Francisco, California; Departments of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California. Electronic address: bbreyer@urology.ucsf.edu. 2. Departments of Obstetrics, Gynecology and Reproductive Sciences, Women's Health Clinical Research Center, University of California-San Francisco, San Francisco, California; Departments of Obstetrics, Gynecology and Reproductive Sciences, University of California-San Francisco, San Francisco, California. 3. Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama. 4. Departments of Obstetrics and Gynecology, Warren Alpert Medical School at Brown University, Providence, Rhode Island. 5. Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Veterans Affairs, Birmingham, Alabama. 6. Miriam Hospital, Providence, Rhode Island; Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, Rhode Island. 7. Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina. 8. National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland. 9. Department of Veterans Affairs, San Francisco, California.
Abstract
PURPOSE: We sought to determine whether a behavioral weight reduction intervention would improve nonurinary incontinence lower urinary tract storage symptoms at 6 months, including urinary frequency, nocturia and urgency, compared to a structured education program serving as the control group among overweight and obese women with urinary incontinence. MATERIALS AND METHODS: PRIDE (Program to Reduce Incontinence by Diet and Exercise) was a randomized clinical trial performed in 338 overweight or obese women with urinary incontinence. Participants were randomized, including 226 to 6-month behavioral weight loss intervention and 112 to the control group. All participants received a self-help behavioral treatment booklet to improve bladder control. On this secondary data analysis we examined changes in nonurinary incontinence lower urinary tract storage symptoms from baseline to 6 months and the impact of treatment allocation (intervention vs control), weight loss and physical activity. RESULTS:Nonurinary incontinence lower urinary tract storage symptoms were common at baseline, varying from 48% to 62%. In the 2 groups combined women experienced significant improvement in nocturia, urgency and International Prostate Symptom Score at 6 months (all p <0.001). However, lower urinary tract storage symptom outcomes at 6 months did not differ between the intervention and control groups. Similarly no difference was observed in the amount of weight lost (5% or greater vs less than 5%) or physical activity (1,500 kcal or greater expenditure per week compared to less than 1,500 kcal). CONCLUSIONS: Lower urinary tract storage symptoms were common among overweight and obese women with urinary incontinence. The prevalence decreased significantly after 6 months independent of treatment group assignment, amount of weight lost or physical activity. These improvements may have been due to self-help behavioral educational materials, trial participation or repeat assessment of symptoms.
RCT Entities:
PURPOSE: We sought to determine whether a behavioral weight reduction intervention would improve nonurinary incontinence lower urinary tract storage symptoms at 6 months, including urinary frequency, nocturia and urgency, compared to a structured education program serving as the control group among overweight and obesewomen with urinary incontinence. MATERIALS AND METHODS: PRIDE (Program to Reduce Incontinence by Diet and Exercise) was a randomized clinical trial performed in 338 overweight or obesewomen with urinary incontinence. Participants were randomized, including 226 to 6-month behavioral weight loss intervention and 112 to the control group. All participants received a self-help behavioral treatment booklet to improve bladder control. On this secondary data analysis we examined changes in nonurinary incontinence lower urinary tract storage symptoms from baseline to 6 months and the impact of treatment allocation (intervention vs control), weight loss and physical activity. RESULTS:Nonurinary incontinence lower urinary tract storage symptoms were common at baseline, varying from 48% to 62%. In the 2 groups combined women experienced significant improvement in nocturia, urgency and International Prostate Symptom Score at 6 months (all p <0.001). However, lower urinary tract storage symptom outcomes at 6 months did not differ between the intervention and control groups. Similarly no difference was observed in the amount of weight lost (5% or greater vs less than 5%) or physical activity (1,500 kcal or greater expenditure per week compared to less than 1,500 kcal). CONCLUSIONS: Lower urinary tract storage symptoms were common among overweight and obesewomen with urinary incontinence. The prevalence decreased significantly after 6 months independent of treatment group assignment, amount of weight lost or physical activity. These improvements may have been due to self-help behavioral educational materials, trial participation or repeat assessment of symptoms.
Authors: Serge Luke; Ben Addison; Katherine Broughton; Jonathan Masters; Richard Stubbs; Andrew Kennedy-Smith Journal: BJU Int Date: 2014-12-08 Impact factor: 5.588
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