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Int Urogynecol J Pelvic Floor Dysfunct 1998;9(3):140-4 The influence of obesity, constitution and physical work on the phenomenon of urinary incontinence in women.Sustersic O, Kralj BUniversity of Ljubljana, University College of Health Care, Slovenia. Urinary incontinence in women is a common and complex problem which can be defined and classified as stress, urge and mixed incontinence. Three of the eight most common risk factors are obesity, constitution and physical work, in addition to age, length of menstrual cycle, number of pregnancies, education and level of health awareness. Women with the diagnosis of urinary incontinence were invited to respond to questionnaires on a voluntary basis. The three factors found to be associated with urinary incontinence are increased body weight, strong osteomuscular structure and hard physical work. These indicate that the work of a health team must take a holistic approach to women even before the phenomenon of urinary incontinence occurs.
J Urol 1998 Sep;160(3 Pt 1):754-5 Surgical correction of stress incontinence in morbidly obese women.Cummings JM, Boullier JA, Parra RODivision of Urology, University of South Alabama, Mobile, USA. PURPOSE: Obesity is a contributing factor to the development of stress urinary incontinence in women, in addition to surgical technical factors which may make some urologists reticent to offer operative therapy. We reviewed our series of morbidly obese women who underwent anti-incontinence surgery to determine if they were at higher risk for surgical failure. MATERIALS AND METHODS: The records of our operative series of female stress urinary incontinence were reviewed and 16 women were considered morbidly obese. Transvaginal bladder neck suspension was performed in 4 women and sling procedures in 12, depending on preoperative urodynamic findings. RESULTS: Bladder neck suspension procedures failed in 2 cases, and no sling procedures failed. There was no recurrent or new pelvic floor deficit. The operations were somewhat more difficult to perform due to the body habitus of these patients but there were no intraoperative complications and only 1 minor wound infection postoperatively. CONCLUSIONS: Morbidly obese women with stress urinary incontinence can undergo operations for this disorder with a good chance of success. We recommend complete evaluation including urodynamics to ensure proper classification of stress incontinence. Sling operations may be the procedure of choice for stress incontinence in morbidly obese women. Ginecol Obstet Mex 1997 Nov;65:458-60 Obesity as a risk factor in surgery for urinary incontinenceRamirez Melgar E, Iris de la Cruz S, Martinez Gonzalez L, Casas Florian A, Valiente Banuet GHospital de Ginecologia y Obstetricia Luis Castelazo Ayala IMSS, Mexico, D.F. There is controversy in the literature related with the prognosis of incontinent obese patient. The objective of this study was to demonstrate if obesity has influence on the relapse of postsurgical incontinence in genuine urinary incontinence. 148 patients were included measuring their Body Mass Index and divided in two groups: Group "A" 74 patients without relapse and Group "B" 74 patients with relapse. The results showed in the obese patients the double of surgical failures than in those with our it (P < 0.05). In conclusion obesity is a adverse prognostic factor in the postsurgical evolution in these patients. Acta Obstet Gynecol Scand 1997 Apr;76(4):359-62 Obesity as a predictor of postpartum urinary symptoms.Rasmussen KL, Krue S, Johansson LE, Knudsen HJ, Agger AODepartment of Gynecology and Obstetrics, Herning Central Hospital, Denmark. BACKGROUND: To investigate the relationship between pre-pregnancy obesity, and urinary symptoms, especially urinary incontinence, before, during, and 6-18 months after delivery. METHODS: Body Mass Index extracted from obstetric records. Postal questionnaire. MATERIAL AND SETTING: One hundred and eight women with Body Mass Index of at least 30 kg/m2 delivered at the Obstetric Department, Herning Central Hospital, October 1994 to September 1995. As control served 108 matched, normal weight women delivering during the same period. RESULT: Response rate was 83%. Stress incontinence, urgency and the feeling of having a hygienic problem was significantly more common after delivery in both groups, but at any time significantly more common among obese women. CONCLUSION: Obesity is a potent risk factor for several urinary symptoms after pregnancy and delivery, and a substantial number of women still have problems 6-18 months postpartum.
Obstet Gynecol 1996 May;87(5 Pt 1):715-21 Urinary incontinence in older women: who is at risk? Study of Osteoporotic Fractures Research Group.Brown JS, Seeley DG, Fong J, Black DM, Ensrud KE, Grady DDepartment of Obstetrics, Gynecology, and Reproductive Sciences, Department of Veterans Affairs, University of California, San Francisco, USA. OBJECTIVE: To estimate the prevalence of and identify factors associated with urinary incontinence in older women. METHODS: A cross-sectional study involved 7949 community-dwelling women, with a mean (+/- standard deviation) age of 76.9 +/- 5.0 years, recruited from population-based listings to participate in the Study of Osteoporotic Fractures. The prevalence and severity of urinary incontinence during the previous 12 months were assessed by questionnaire. Factors potentially associated with urinary incontinence were assessed by questionnaire, interview, and physical examination. Multivariate logistic regression analysis was used to determine the independent associations between these factors and the primary outcome of daily incontinence. RESULTS: Forty-one percent (3285) of the women reported urinary incontinence, with 14% (1130) reporting daily incontinence. In multivariate analysis, the prevalence of daily urinary incontinence increased significantly with age , prior hysterectomy, Obesity. CONCLUSION: Urinary incontinence is a common problem in older women, more common than most chronic medical conditions. Of the associated factors that are preventable or modifiable, obesity and hysterectomy may have the greatest impact on the prevalence of daily incontinence. Am J Obstet Gynecol 1992 Aug;167(2):392-7; discussion 397-9 Obesity and lower urinary tract function in women: effect of surgically induced weight loss.Bump RC, Sugerman HJ, Fantl JA, McClish DKDepartment of Obstetrics and Gynecology, Medical College of Virginia/Virginia Commonwealth University, Richmond. OBJECTIVE: The subjective and objective effects of massive weight loss on lower urinary tract function in morbidly obese women were examined. STUDY DESIGN: Thirteen subjects underwent a comprehensive evaluation of lower urinary tract function before and 1 year after surgically induced weight loss. RESULTS: We demonstrated significant improvements in lower urinary tract function after weight loss. Of 12 subjects who complained of incontinence before surgery only three complained of incontinence (p = 0.004) and only one requested treatment after weight loss. Objective and subjective resolution of both stress and urge incontinence was documented. Statistically significant changes were seen in measures of vesical pressure, the magnitude of bladder pressure increases with coughing, bladder-to-urethra pressure transmission with cough, urethral axial mobility, number of incontinence episodes, and the need to use absorptive pads. CONCLUSION: Weight reduction is desirable for obese women complaining of urinary incontinence and may obviate the need for further incontinence therapy.
Urol Int 1988;43(1):7-10 Obesity and stress urinary incontinence: significance of indices of relative weight.Kolbl H, Riss PSecond Department of Obstetrics and Gynecology, University Hospital of Vienna, Austria. We analyzed the significance of weight and various indices of relative weight in the assessment of genuine stress incontinence (GSI) in 193 female patients. Body mass index [BMI = weight/(height2)] and the other indices of relative weight [weight/height - weight/(height3)] were not markedly different between patients with GSI and a control group of 43 females without demonstrable incontinence. A markedly increased BMI was found to be correlated with a positive clinical stress test. In addition BMI was significantly higher in patients with a higher maximum urethral pressure. We conclude that although obese women tend to have a higher prevalence of positive clinical stress test. Br J Obstet Gynaecol 1988 Jan;95(1):91-6 Obesity and urinary incontinence in women.Dwyer PL, Lee ET, Hay DMDepartment of Gynaecology, Princess Royal Hospital, Hull. In a series of 368 incontinent women who presented to our urodynamic clinic
for assessment, 232 (63%) were diagnosed as having genuine stress incontinence,
and 136 (27%) as having detrusor instability. Obesity (greater than 20% more
than average weight for height and age) was significantly more common in women
with genuine stress incontinence and detrusor instability than in the normal
population. |
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