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Association between overweight and lower urinary tract symptoms in children and adolescents: A systematic review and
Beom Yong Rho1, Si Wook Lee2, Yong Seung Lee3
1Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea; Department of Urology, Inha University College of Medicine, Incheon, South Korea.
Insights
Childhood obesity is linked to increased lower urinary tract symptoms (LUTS) in children and adolescents, especially nocturnal enuresis. This meta-analysis highlights obesity as a risk factor, informing clinical strategies for prevention and management.
Area of Science:
- Pediatric Urology
- Public Health
- Obesity Research
Background:
- Childhood obesity is a significant public health issue with potential links to lower urinary tract symptoms (LUTS).
- Existing research on the association between obesity and LUTS in pediatric populations shows inconsistent findings regarding symptom types.
- A comprehensive evaluation is needed to clarify the relationship between overweight/obesity and LUTS in children and adolescents.
Purpose of the Study:
- To conduct a meta-analysis assessing the association between overweight or obesity and LUTS in children and adolescents.
- To synthesize evidence from existing studies to determine the impact of obesity on different types of LUTS.
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, and Cochrane Library.
- Keywords related to obesity, overweight, and LUTS in pediatric and adolescent populations were used.
- The search was last updated on July 1, 2023.
Main Results:
- The meta-analysis included 11 studies with 31,754 participants.
- Obesity was associated with a higher rate of enuresis (RR = 1.44) and overactive bladder (OAB) (RR = 1.59).
- An elevated risk of daytime urinary incontinence (DUI) was observed (RR = 1.64), but it was not statistically significant.
Conclusions:
- Obesity is identified as a potential risk factor for LUTS in the pediatric and adolescent population.
- Nocturnal enuresis appears to be particularly associated with obesity in this age group.
- Findings can guide clinical interventions and preventive measures to address the impact of overweight on pediatric LUTS.
Objectives:
Childhood obesity is a growing public health concern linked to various health complications, including lower urinary tract symptoms (LUTS), which can significantly affect quality of life. Despite evidence suggesting an association between obesity and LUTS, existing studies report inconsistent findings regarding whether obesity predominantly affects bladder storage symptoms or both storage and voiding functions, necessitating a comprehensive evaluation. This meta-analysis aimed to assess the association between overweight or obesity and LUTS in children and adolescents.
Method:
A comprehensive search of the PubMed, Embase, and Cochrane Library was performed using controlled vocabulary (MESH, EMTREE) and free-text keywords related to obesity, overweight, and LUTS in pediatric and adolescent populations. The search was conducted on July 1, 2023.
Results:
Among the 11 studies involving 31,754 patients, 8, 4, and 5 studies pertained to enuresis, daytime urinary incontinence (DUI), and overactive bladders, respectively. Patients with obesity had a higher rate of enuresis (RR = 1.44; 95 % [CI], 1.19-1.74; I2 = 64.7 %, p < 0.001) and were more likely to have OAB (RR = 1.59; 95 % CI, 1.13-2.24; I2 = 80.8 %, p = 0.008). The risk of DUI was also elevated (RR = 1.64; 95 % CI, 0.97-2.77; I2 = 74 %, p = 0.07), though not statistically significant.
Conclusion:
Obesity appears to be a potential risk factor for LUTS in children and adolescents, particularly nocturnal enuresis. These findings may inform clinical strategies and preventive interventions to mitigate the adverse impact of overweight on pediatric LUTS.
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