Friday, January 29, 2010

Does obesity in adolescent girls lead to urinary incontinence?

We know, from the news and medical reports, that American kids are fat, and fatter than they have ever been. Whether due to video games or junk food, obesity in children and adolescents has doubled in the past three decades. A survey in 2004 on nutrition and health done in the USD showed that 17% of children and adolescents in the US are obese (BMI >95% percentile for age and sex). Unfortunately, obese children and adolescents suffer from the same health issues as obese adults: diabetes, high blood pressure, high lipids/cholesterol, sleep apnea, joint problems and psychological issues.

It is well known that obesity is a risk factor for urinary incontinence and that weight loss can significantly improve both stress and urge incontinence, and that diabetes has been correlated to urinary incontinence. Constipation and stool soiling is also more common in obese children, and constipation can also lead to urinary incontinence in both adults and children. Therefore the logical question is: are obesity girls (children and adolescents) at higher risk for urinary incontinence?

A recent study from Minnesota looked at this very question. 40 obese girls and 20 non-obese girls between the ages of 12 and 17 were recruited to answer a questionnaire. The kids were examined and weighed. Incontinence of urine was defined as leaking once or more per week. Questions regarding stress and urge incontinence were asked.

Among the obese girls, 12.5% reported incontinence at least about once a week. None of non-obese girls reported any incontinence meeting this definition. Infrequent leakage (less than once a month) with low volume occurred in both 45% of the obese and non-obese girls. The impact of incontinence was more severe in the obese girls in terms of degree of “bother”. Children with daytime wetting have been reported to have lower self-esteem. This is all the more relevant, as the authors state, that obese children and adolescents may be reluctant to report it, are embarrassed about it, and may not know there is treatment. On the basis of this, pediatricians, and other health care providers should gently ask their patients about such topics in order to offer assistance. First line remedies that are safe include weight loss (non-surgical), Kegel exercises, and even medications that aide bedwetters.

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