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Review
. 2021 Jan;10(1):494-503.
doi: 10.21037/tau-20-1217.

Progress in studies on pathological changes and future treatment strategies of obesity-associated female stress urinary incontinence: a narrative review

Jiancheng Pan  1   2 , Enli Liang  1   2 , Qiliang Cai  1   2 , Dingrong Zhang  1   2 , Jiang Wang  1   2 , Yuhong Feng  1   2 , Xiaoqing Yang  1   2 , Yongjiao Yang  1   2 , Wenjie Tian  3 , Changyi Quan  1   2 , Ruifa Han  1   2 , Yuanjie Niu  1   2 , Yegang Chen  1   2 , Zhongcheng Xin  1   2   4
Affiliations
Review

Progress in studies on pathological changes and future treatment strategies of obesity-associated female stress urinary incontinence: a narrative review

Jiancheng Pan et al. Transl Androl Urol. 2021 Jan.

Abstract

With the increasing prevalence of obesity worldwide, obesity-related female stress urinary incontinence (FSUI) has become a key health problem. Recent studies indicated that FSUI is primarily caused by obesity-related pathological changes, such as fat droplet deposition, and results in pelvic floor nerve, vascular, and urethral striated muscle injury. Meanwhile, treatments for obesity-associated FSUI (OA-FSUI) have garnered much attention. Although existing OA-FSUI management strategies, including weight loss, pelvic floor muscle exercise, and urethral sling operation, could play a role in symptomatic relief; they cannot reverse the pathological changes in OA-FSUI. The continued exploration of safe and reliable treatments has led to regenerative therapy becoming a particularly promising area of researches. Specifically, micro-energy, such as low-intensity pulsed ultrasound (LIPUS), low-intensity extracorporeal shock wave therapy (Li-ESWT), and pulsed electromagnetic field (PEMF), have been shown to restore the underlying pathological changes of OA-FSUI, which might be related by regulation endogenous stem cells (ESCs) to restore urine control function ultimately in animal experiments. Therefore, ESCs may be a target for repairing pathological changes of OA-FSUI. The aim of this review was to summarize the OA-FSUI-related pathogenesis, current treatments, and to discuss potential therapeutic options. In particular, this review is focused on the effects and related mechanisms of micro-energy therapy for OA-FSUI to provide a reference for future basically and clinical researches.

Keywords: Obesity-associated female stress urinary incontinence (OA-FSUI); endogenous stem cells (ESCs); low-intensity extracorporeal shock wave therapy (Li-ESWT); low-intensity pulsed ultrasound (LIPUS); pathology; regeneration.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tau-20-1217). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Mechanism of micro-energy therapy regulating the biological behavior of endogenous stem cells (ESCs).
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