Up to 50% of adult women report urinary incontinence (UI). It has a major impact on quality of life, equivalent to diabetes or rheumatoid arthritis. Similarly, obesity is also an increasing worldwide epidemic with pervasive associations with arthritis, hypertension, diabetes, cancer and cardiova. Aging, childbirth and overweight and obesity are identified as the three major risk . Age and parity are not modifiable, but being overweight or obesity is potentially highly modifiable. Many epidemiological studies have shown a positive association between incontinence and obesity in women. There is a clear dose-response effect of weight on UI with each 5-unit increase in BMI being associated with 20% to 70% increase in the risk of daily incontinence. However, the literature regarding the relationship between obesity and the different subtypes of incontinence is mixed. In EPINCONT, the largest population based study of urinary symptoms; a high BMI was associated with each type of UI, with the strongest association in severe mixed incontinence. A subsequent large systematic review suggested a stronger association between weight and stress incontinence, than for urgency incontinence and overactive bladder syndrome. However, in another study of obese women with a BMI greater than 40kg/m2 who were planning weight reduction surgery the prevalence of incontinence was 60% to 70% with a prevalence of 28% for pure stress type, 4% for pure urge type and 32% for mixed type. In the population- based FINNO study, obesity doubled the risk of stress incontinence and tripled the risk of urgency incontinence. Longitudinal cohort studies have demonstrated an association of overweight and obesity with incident UI, providing evidence for a temporal relationship between a possible cause and an outcome. In 5-10 years follow up the odds of incident UI increased by around 7%-12% for each 1kg/m2 unit increase in BMI. This association was again strongest for stress and mixed incontinence, and weaker for urge incontinence and overactive bladder syndrome.

With Regards,
Sara Giselle
Associate Managing Editor
 Journal of Critical Care Obsestrics & Gynocology