Obesity and Overactive Bladder: Is It a Matter of Body Weight, Fat Distribution or Function? A Preliminary Results



      To determine the relationship between subcutaneous fat, visceral fat surface area (VFA), bladder wall fat distribution, and visceral adiposity index (VAI) as risk factors for overactive bladder (OAB) occurrence.

      Patients and Methods

      A cross-sectional study involved 157 participants was conducted. The participants were divided into 2 groups; study group (87 patients diagnosed with OAB) and control group (70 healthy participants). All participants were evaluated for OAB using short-form OABSS version. Physical examination including waist circumference (WC) measurement in addition to metabolic laboratory investigations (eg, High density lipoprotein (HDL), cholesterol, etc) were done. Study group underwent urodynamic testing. Using noncontrast spiral CT abdomen and pelvis, trunkal fat measurements and bladder wall fat distribution were detected. VAI was calculated for both females and males. Univariate and multivariate analyses were done to detect risk factors for OAB occurrence. Correlation between all factors and total OABSS and urodynamics was done.


      The mean age ± SD was 40.4 ± 9 years. In multivariate analysis, increased VFA, higher cholesterol level, increased VAI and focal fat distribution at bladder wall were associated with 9.4, 1.98, 5.5, and 1.6 times higher risk for OAB occurrence. VAI and VFA were strongly correlated with total OABSS, DLPP, amplitude, and frequency of bladder detrusor contractions. On the other hand, WC and body mass index were not correlated significantly.


      Body mass index and WC are crude inaccurate methods correlated with OAB presence. Focal bladder wall fat distribution, higher VAI, higher VFA are novel risk factors for OAB occurrence. Both VAI and VFA are correlated significantly to total OABSS and urodynamics findings in patients with OAB.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Lightner DJ
        • Agarwal D
        • Gormley EA
        The overactive bladder and the AUA guidelines: a proposed clinical pathway for evaluation and effective management in a contemporary urology practice.
        Urol Pract. 2016; 3: 399-405
        • Groen J
        • Pannek J
        • Diaz DC
        • et al.
        Summary of European Association of Urology (EAU) guidelines on neuro-urology.
        Eur Urol. 2016; 69: 324-333
        • Hunskaar S
        A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women.
        Neurourol Urodyn. 2008; 27: 749-757
        • Lee RK
        • Chung D
        • Chughtai B
        • Te AE
        • Kaplan SA
        Central obesity as measured by waist circumference is predictive of severity of lower urinary tract symptoms.
        BJU Int. 2012; 110: 540-545
        • Link CL
        • Steers WD
        • Kusek JW
        • McKinlay JB
        The association of adiposity and overactive bladder appears to differ by gender: results from the Boston Area Community Health survey.
        J Urol. 2011; 185: 955-963
        • Townsend MK
        • Curhan GC
        • Resnick NM
        • Grodstein F
        BMI, waist circumference, and incident urinary incontinence in older women.
        Obesity. 2008; 16: 881-886
        • Bunn F
        • Kirby M
        • Pinkney E
        • et al.
        Is there a link between overactive bladder and the metabolic syndrome in women? A systematic review of observational studies.
        Int J Clin Pract. 2015; 69: 199-217
        • Wajchenberg BL
        Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome.
        Endocr Rev. 2000; 21: 697-738
        • De Boer TA
        • Slieker-ten Hove MC
        • Burger CW
        • Vierhout ME
        The prevalence and risk factors of overactive bladder symptoms and its relation to pelvic organ prolapse symptoms in a general female population.
        Int Urogynecol J. 2011; 22: 569-575
        • Teleman PM
        • Lidfeldt J
        • Nerbrand C
        • Samsioe G
        • Mattiasson A
        • Group WS
        Overactive bladder: prevalence, risk factors and relation to stress incontinence in middle‐aged women.
        BJOG. 2004; 111: 600-604
        • Lai HH
        • Helmuth ME
        • Smith AR
        • Wiseman JB
        • Gillespie BW
        • Kirkali Z
        Relationship between central obesity, general obesity, overactive bladder syndrome and urinary incontinence among male and female patients seeking care for their lower urinary tract symptoms.
        Urology. 2019; 123: 34-43
        • McGrother CW
        • Donaldson MM
        • Hayward T
        • Matthews R
        • Dallosso HM
        • Hyde C
        Urinary storage symptoms and comorbidities: a prospective population cohort study in middle-aged and older women.
        Age Ageing. 2005; 35: 16-24
        • Uzun H
        • Zorba OÜ
        Metabolic syndrome in female patients with overactive bladder.
        Urology. 2012; 79: 72-75
        • Harisinghani MG
        • Wittenberg J
        • Lee W
        • Chen S
        • Gutierrez AL
        • Mueller PR
        Bowel wall fat halo sign in patients without intestinal disease.
        Am J Roentgenol. 2003; 181: 781-784
        • Dursun M
        • Otunctemur A
        • Ozbek E
        • Sahin S
        • Besiroglu H
        • Koklu I
        Stress urinary incontinence and visceral adipose index: a new risk parameter.
        Int Urol Nephrol. 2014; 46: 2297-2300
        • Amato MC
        • Giordano C
        • Galia M
        • et al.
        Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk.
        Diabetes Care. 2010; 33: 920-922
        • Truzzi JC
        • Gomes CM
        • Bezerra CA
        • et al.
        Overactive bladder–18 years–Part II.
        Int Braz J Urol. 2016; 42: 199-214
        • Schäfer W
        • Abrams P
        • Liao L
        • et al.
        Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies.
        Neurourol Urodyn. 2002; 21: 261-274
        • Kriegshauser JS
        • Conley CR
        • Hentz JG
        Bladder wall fat on computed tomography with pathologic correlation.
        Clin Imaging. 2013; 37: 509-513
        • Haylen BT
        • de Ridder D
        • Freeman RM
        • et al.
        An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction.
        Neurourol Urodyn. 2010; 29: 4-20
        • Peyronnet B
        • Mironska E
        • Chapple C
        • et al.
        A comprehensive review of overactive bladder pathophysiology: on the way to tailored treatment.
        Eur Urol. 2019; 75: 988-1000
        • Al-Shaiji TF
        • Radomski SB
        Relationship between body mass index and overactive bladder in women and correlations with urodynamic evaluation.
        Int Neurourol J. 2012; 16: 126