一项行为体重管理计划对超重肥胖伴尿失禁女性下尿路症状（包括非尿失禁症状）的影响：PRIDE 的二次数据分析
A Behavioral Weight Loss Program and Nonurinary Incontinence Lower Urinary Tract Symptoms in Overweight and Obese Women with Urinary Incontinence: A Secondary Data Analysis of PRIDE.
机构信息
Departments of Urology and Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California; Department of Urology, University of California-San Francisco, San Francisco, California; Departments of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California.
Departments of Obstetrics, Gynecology and Reproductive Sciences, Women's Health Clinical Research Center, University of California-San Francisco, San Francisco, California; Departments of Obstetrics, Gynecology and Reproductive Sciences, University of California-San Francisco, San Francisco, California.
出版信息
J Urol. 2018 Jan;199(1):215-222. doi: 10.1016/j.juro.2017.07.087. Epub 2017 Aug 12.
PURPOSE
We sought to determine whether a behavioral weight reduction intervention would improve nonurinary incontinence lower urinary tract storage symptoms at 6 months, including urinary frequency, nocturia and urgency, compared to a structured education program serving as the control group among overweight and obese women with urinary incontinence.
MATERIALS AND METHODS
PRIDE (Program to Reduce Incontinence by Diet and Exercise) was a randomized clinical trial performed in 338 overweight or obese women with urinary incontinence. Participants were randomized, including 226 to 6-month behavioral weight loss intervention and 112 to the control group. All participants received a self-help behavioral treatment booklet to improve bladder control. On this secondary data analysis we examined changes in nonurinary incontinence lower urinary tract storage symptoms from baseline to 6 months and the impact of treatment allocation (intervention vs control), weight loss and physical activity.
RESULTS
Nonurinary incontinence lower urinary tract storage symptoms were common at baseline, varying from 48% to 62%. In the 2 groups combined women experienced significant improvement in nocturia, urgency and International Prostate Symptom Score at 6 months (all p <0.001). However, lower urinary tract storage symptom outcomes at 6 months did not differ between the intervention and control groups. Similarly no difference was observed in the amount of weight lost (5% or greater vs less than 5%) or physical activity (1,500 kcal or greater expenditure per week compared to less than 1,500 kcal).
CONCLUSIONS
Lower urinary tract storage symptoms were common among overweight and obese women with urinary incontinence. The prevalence decreased significantly after 6 months independent of treatment group assignment, amount of weight lost or physical activity. These improvements may have been due to self-help behavioral educational materials, trial participation or repeat assessment of symptoms.
目的
我们旨在确定行为减肥干预是否会改善超重和肥胖的尿失禁女性的非尿失禁下尿路储存症状（包括尿频、夜尿和尿急），与作为对照组的结构化教育计划相比，在 6 个月时，包括尿频率、夜尿和紧迫性。
材料和方法
PRIDE（通过饮食和运动减少失禁计划）是一项在 338 名超重或肥胖的尿失禁女性中进行的随机临床试验。参与者被随机分组，包括 226 名接受 6 个月行为减肥干预的参与者和 112 名对照组参与者。所有参与者都收到了一本自我帮助的行为治疗手册，以改善膀胱控制。在这项二次数据分析中，我们检查了从基线到 6 个月时非尿失禁下尿路储存症状的变化，以及治疗分配（干预与对照）、体重减轻和体力活动的影响。
结果
非尿失禁下尿路储存症状在基线时很常见，从 48%到 62%不等。在两组合并的女性中，夜尿、尿急和国际前列腺症状评分在 6 个月时均有显著改善（均 p <0.001）。然而，干预组和对照组之间 6 个月时的下尿路储存症状结果没有差异。同样，体重减轻量（5%或更多与小于 5%）或体力活动（每周 1500 卡路里或更多与小于 1500 卡路里）之间也没有差异。
结论
下尿路储存症状在超重和肥胖的尿失禁女性中很常见。6 个月后，无论治疗组分配、体重减轻量或体力活动如何，下尿路储存症状的患病率都显著下降。这些改善可能是由于自我帮助的行为教育材料、试验参与或症状的重复评估。
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