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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 于博芮 | 減重可治療體重過重婦女的尿失禁問題 | 2009/3/18 上午 09:10:10 | 0 |
| 原 文 | 題 目 | Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women |
| 作 者 | Leslee L. Subak | |
| 出 處 | The new england journal o f medicine, 360;5, p481-490 | |
| 出版日期 | january 29, 2009 | |
| 評 論 | 由於營養攝取的不均衡，現代人易出現肥胖問題，而肥胖也是導致代謝症候群的原因之ㄧ。肥胖者也易出現尿失禁的問題，然而減重後是否會緩解尿失禁的現象？缺乏實證資料，本研究以隨機分派個案至控制組與實驗組中，兩組皆提供自我學習骨盆底肌訓練手冊，實驗組進行減重活動。六個月後減重組尿失禁次數減少且達統計差異，不過本研究未對骨盆底肌訓練的影響多討論，減重與骨盆底肌訓練對於肥胖者失禁緩解何者較重要？或許是未來研究探討重點。 | |
| abstract |
Background Obesity is an established and modifiable risk factor for urinary incontinence, but conclusive evidence for a beneficial effect of weight loss on urinary incontinence is lacking. Methods We randomly assigned 338 overweight and obese women with at least 10 urinaryincontinence episodes per week to an intensive 6-month weight-loss program that included diet, exercise, and behavior modification (226 patients) or to a structured education program (112 patients). Results The mean (±SD) age of the participants was 53±11 years. The body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) and the weekly number of incontinence episodes as recorded in a 7-day diary of voiding were similar in the intervention group and the control group at baseline (BMI, 36±6 and 36±5, respectively; incontinence episodes, 24±18 and 24±16, respectively). The women in the intervention group had a mean weight loss of 8.0% (7.8 kg), as compared with 1.6% (1.5 kg) in the control group (P<0.001). After 6 months, the mean weekly number of incontinence episodes decreased by 47% in the intervention group, as compared with 28% in the control group (P = 0.01). As compared with the control group, the intervention group had a greater decrease in the frequency of stressincontinence episodes (P = 0.02), but not of urge-incontinence episodes (P = 0.14). A higher proportion of the intervention group than of the control group had a clinically relevant reduction of 70% or more in the frequency of all incontinence episodes (P<0.001), stress-incontinence episodes (P = 0.009), and urge-incontinence episodes (P = 0.04). Conclusions A 6-month behavioral intervention targeting weight loss reduced the frequency of self-reported urinary-incontinence episodes among overweight and obese women as compared with a control group. A decrease in urinary incontinence may be another benefit among the extensive health improvements associated with moderate weight reduction. |
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