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Risk of incontinence increased in obese women.

SAVANNAH, GA. -- Obesity appears to confer a fourfold increased risk for urinary incontinence and twofold increased risk for anal incontinence, according to a study presented as a poster at the annual meeting of the Society of Gynecologic Surgeons.

In a study of more than 400 women, those who were obese were four times more likely to suffer from urinary incontinence than were their normal-weight counterparts, after adjustment for demographics, medical history, menopausal status, parity, and number of C-sections. Obese women were also twice as likely to have anal incontinence than were normal-weight women, reported Dr. Chi Chiung Grace Chen, of the department of gynecology and obstetrics at the Cleveland Clinic Foundation, and her colleagues.

The researchers questioned obese and morbidly obese women (body mass index greater than or equal to 30 kg / [m.sup.2]) who were contemplating having bariatric surgery and normal-weight women (BMI less than 30) who were receiving routine gynecologic care between 2006 and 2007 about pelvic floor disorder symptoms. The questionnaire asked specifically about symptoms of stress urinary incontinence (SUI), urge urinary incontinence (UUI), pelvic organ prolapse (POP), and anal incontinence (AI). In all, 217 obese or morbidly obese women and 210 normal-weight women were included in the study.

Urinary incontinence severity was classified as slight, moderate, or severe based on responses to the Sandvik incontinence severity index. Anal incontinence severity was measured using the Rockwood fecal incontinence severity index; higher scores indicated greater severity.

The prevalence of pelvic floor disorders, including SUI, UUI, and all types of AI, was higher in the obese and morbidly obese patients than in the normal-weight women. The prevalence of urinary incontinence was 71% in the obese group and 38% in the normal-weight group. Of the obese women, 60% and 53% had SUI and UUI, respectively. By comparison, 28% and 26% of the normal-weight women had SUI and UUI, respectively. POP was comparable in the two groups--4% of obese women and 5% of normal-weight women. The prevalence of anal incontinence was 25% for obese women, compared with 10% for normal-weight women.

"Obesity was associated with increased severity of urinary and anal incontinence," the researchers wrote in their presentation at the meeting, which was jointly sponsored by the American College of Surgeons.

In terms of urinary incontinence severity, 44% of obese women and 74% of normal-weight women were classified as slight. More obese women had moderate (32%) or severe (23%) urinary incontinence than did normal-weight women (20% and 6%, respectively).

Likewise, obese women had more severe anal incontinence, with a mean Rockwood score of 21, compared with 15 for normal-weight women. All of the findings were statistically significant.

Dr. Chen reported that she had no relevant financial relationships.
Prevalence of Urinary and Anal Incontinence Higher in Obese Women

 Urinary Anal
 Incontinence incontinence

Obese or morbidly obese (n = 217) 71% 25%
Normal weight (n = 210) 38% 10%

Source: Dr. Chen


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Title Annotation:Women's Health
Author:Wachter, Kerri
Publication:Internal Medicine News
Geographic Code:1USA
Date:Jul 15, 2008
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