The facts about lifestyle changes for treating urinary incontinence

This analysis investigated the effects of lifestyle changes on urinary incontinence.

Lifestyle changes are often recommended for the treatment of urinary incontinence. Advice commonly given includes losing weight, changes in diet, adjusting fluid intake, decreasing caffeine or alcohol consumption, treating constipation, stopping smoking, and increasing physical activity.

While many of these changes seem to improve urinary function, they are rarely based on high-quality evidence.

This analysis reviewed recent studies that compared the effects of lifestyle alterations with either no treatment, or other known treatments for urinary incontinence. Eleven studies, including 5974 participants (nearly all women, only 20 were men), were investigated.

Findings from four low quality studies suggested that weight loss may reduce incontinence among overweight women.  76% of women participating in weight loss programs reported improvements in symptoms of incontinence.

Three trials compared change in fluid intake with no change. Low quality evidence suggested that quality of life scores (as reported by patients) improved when fluid intake was reduced. Reported side-effects of reduced fluid intake included headaches, constipation and thirst.

Three trials compared reduction in caffeinated drinks with no change. Although some studies reported improvements in urinary function, no definitive conclusions could be reached due to very low quality of evidence.

One small trial compared a soy-rich diet with soy-free diet. Again, no conclusions were reached due to very low quality evidence.

No evidence from controlled trials was available regarding other lifestyle interventions (such as reduced consumption of carbonated drinks, reduction in alcohol consumption, avoiding constipation, smoking cessation, and changing levels of physical activity). The effects of such interventions could not be assessed in this review.

The review concluded that there is not enough high-quality evidence to establish whether any lifestyle change works for treating urinary incontinence. Weight loss seems to improve urinary incontinence and should be a research priority.