Efficacy of Body Weight Reduction in Improving Overactive Bladder Symptoms in Obese and Overweight Women: A Systematic Review

Abstract

Context: Elevated BMI has been linked to urinary incontinence (UI), including Stress Urinary Incontinence (SUI), urge urinary incontinence (UUI), and overactive bladder (OAB). Overactive bladder is associated with a lower quality of life compared to other types of UI. Objectives: The objective of this review is to evaluate the effect of weight loss programs on reducing UI symptoms in obese and overweight female patients with OAB. Methods: We conducted a literature search in PubMed, EBSCOhost, ProQuest, Embase, Scopus, and Cochrane. The outcomes assessed included the improvement of OAB symptoms, cure rates for OAB, duration of symptom improvement, and quality of life. The risk of bias was assessed using the risk of bias in non-randomized studies of intervention (ROBINS-I) tool. Results: Ten clinical studies, comprising 1,049 patients who underwent surgical procedures and 408 patients engaged in behavioral weight reduction, were included in the analysis. A significant decrease in the Overactive Bladder Severity Score (OABSS) was observed in patients who participated in the weight loss program. The OAB cure rate showed improvement (38% - 73%) and decreased the prevalence of OAB and UUI. However, the dropout rates were high, and the results became insignificant in up to 18 months of follow-up due to weight gain. Surgical procedures for reducing BMI generally improve OAB symptoms better; however, several complications have been recorded, prompting consideration of the patient’s risk of morbidity and mortality. Conclusions: The weight loss program has been shown to be effective in reducing UI symptoms in patients with OAB. Patients who underwent surgical procedures to reduce weight showed better improvement in UI symptoms compared to other approaches.