Program to Reduce Incontinence by Diet and Exercise (PRIDE)

尿失禁是女性的常见问题，会导致痛苦、生活质量下降。 以及日常运作的戏剧性限制。超重女性患尿病的风险显著增加 大小便失禁和超过65%的大小便失禁妇女超重。来自短期、初步的数据 研究表明，减肥可以显著减少大小便失禁的发作。因此，减肥可以 提出了一种很有希望的治疗尿失禁的新方法，这种方法可能会产生一连串的 除了减少尿失禁的频率外，更广泛的健康改善。因此，我们 建议将330名患有尿失禁的超重和肥胖女性(两人各165人)随机分组 临床中心)到为期6个月的强化行为体重控制计划或常规护理，以确定 减肥对大小便失禁频率和生活质量的短期影响，最有可能识别女性 从减肥中受益，并开始探索尿失禁的尿动力学机制 体重减轻后的改善。 为了最大限度地减轻体重对尿失禁的持久影响，有必要生产 体重持续下降。然而，在肥胖领域，保持体重仍然是一个挑战。因此， 我们建议评估一项创新的、理论指导的体重维持计划，该计划将重点放在 增加改变行为的动力和承诺，并将其与更多的标准进行比较， 注重技能的体重维持计划。在完成为期6个月的减肥计划后， 减肥组将随机接受为期12个月的基于技能的标准维护计划或 以激励为重点的维护干预。结果包括体重减轻、大小便失禁频率 18个月时的生活质量。如果对大小便失禁的女性有效，那么这种治疗的方法和策略 创新的以动机为重点的维持干预可以在其他肥胖人群中进行检查。 为失禁网络减轻体重-汇集了一组独特的杰出和 在尿失禁、肥胖治疗和多中心合作方面经验丰富的研究人员- 在三个机构进行了前瞻性临床试验。建议的研究设计将使我们能够有效地评估 治疗尿失禁的新疗法和增强体重维持的有前景的方法， 并因此为几个对妇女健康至关重要的临床领域做出实质性贡献。

Urinary incontinence is a common problem among women that causes distress, diminished quality of life and dramatic limitations in daily functioning. Overweight women are at significantly increased risk of urinary incontinence and over 65% of women with incontinence are overweight. Data from short-term, preliminary studies suggest that weight reduction may significantly reduce incontinence episodes. Thus, weight loss may present a promising new approach to urinary incontinence treatment, one likely to produce a cascade of broader health improvements in addition to reductions in frequency of urinary incontinence. Therefore, we propose to randomize 330 overweight and obese women with urinary incontinence (165 at each of two clinical centers) to a 6-month intensive behavioral weight control program or to usual care to determine the short-term effect of weight loss on frequency of incontinence and quality of life, to identify women most likely to benefit from weight loss and to begin to explore the urodynamic mechanisms underlying incontinence improvement following weight loss. To maximize enduring effects of weight loss on urinary incontinence, it will be necessary to produce sustained weig.ht loss. However, weight maintenance remains a challenge in the obesity field. Therefore, we propose to evaluate an innovative, theory-guided weight maintenance program that will focus on increasing motivation and commitment to behavior change efforts and compare this with a more standard, skills-focused weight maintenance program. After completing the 6-month weight loss program, women in the weight loss arm will be randomized to either a 12-month standard, skill-based maintenance program or to a motivationally-focused maintenance intervention. Outcomes will include weight loss, incontinence frequency and quality of life at 18 months. If effective in women with incontinence, the methods and strategies of this innovative motivationally-focused maintenance intervention can be examined in other obese populations. WIN - Weight Reduction for Incontinence Network - brings together a unique group of outstanding and experienced investigators with expertise in urinary incontinence, obesity treatment and multicenter collabora- tive clinical trials at three institutions. The proposed study design will allow us to efficiently evaluate both a novel treatment for urinary incontinence and a promising approach to enhancement of weight maintenance, and therefore to make substantive contributions to several clinical arenas critical to women's health.