European Journal of Obstetrics and Gynecology 295 (2024) 59–64 Available online 6 February 2024 0301-2115/© 2024 Elsevier B.V. All rights reserved. Full length article Prevalence of overactive bladder among overweight and obese women: A prospective cross-sectional cohort study Baydaa Alsannan a, * , Antonio Simone Lagan` a b , Jehad Alhermi a , Shaikha Almansoor c , Amal Ayed c , Renato Venezia b , Andrea Etrusco b a Department of Obstetrics and Gynecology, College of Medicine, Kuwait University, 13110 Safat, Kuwait b Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy c Kuwait Ministry of Health, 13110 Safat, Kuwait A R T I C L E INFO Keywords: Overactive bladder Body mass index Overweight Obesity Urinary incontinence Urogynecology ABSTRACT Objective: To evaluate the effect of body mass index (BMI) on the prevalence of overactive bladder syndrome (OAB), severity of symptoms, and quality of life in affected patients. Methods: We conducted a prospective cross-sectional study of 1351 consecutive patients who were recruited between June 2021 and May 2022. Patients were divided according to BMI (normal: <25.0, overweight: 25–29.9, obese: ≥30) and menopausal status. The latter were divided according to the presence or absence of urinary incontinence in the normal, wet-OAB and dry-OAB groups. A validated questionnaire, the International Consultation on Incontinence Questionnaire in Overactive Bladder (ICIQ-OAB), in the English and Arabic lan- guages was used. Results: A total of 1351 patients were included. For women who were overweight, there was a greater prevalence of dry-OAB (p = 0.02), However, the prevalence of both dry and wet-OAB were higher in obese women (p < 0.00001). Compared to women with a normal BMI, women who were overweight or obese had a greater like- lihood of developing abnormal daytime urine frequency and nocturia, with p values ≤ 0.01. The ORs of over- weight and obese women were 3.1 and 5.3, respectively, for experiencing wet OAB in comparison to women with a normal BMI. Additionally, the odds of developing severe OAB in overweight and obese women were 5.8 and 18.6, respectively, which negatively affects their quality of life (QoL). Conclusion: The risk of developing OAB symptomatology is signifcantly greater in overweight and obese patients. As BMI increases, the symptomatology, perceived discomfort and QoL of patients with OAB worsen. Introduction Overactive bladder (OAB) is an entity that affects and negatively impacts the quality of life (QoL) and sexual function of approximately 12 % of the adult female population [1]. The International Urogyneco- logical Association (IUGA) and the International Continence Society (ICS) defne urinary urgency as a complex of symptoms defned by increased daytime frequency and nocturia with or without urinary in- continence in the absence of pathologic or metabolic conditions that may explain these symptoms [2]. OAB can also be divided into wet-OAB and dry-OAB based on the presence or absence of urgency incontinence, respectively. There is a signifcant increase in overweight and obesity among young people, with negative consequences for the development of obesity and related diseases [3,4]. Overweight was defned as a body mass index (BMI) between 25 and 29.9; obesity was divided into 3 classes based on BMI: class I obesity, with a BMI between 30.0 and 34.9; class II obesity, with a BMI between 35.0 and 39.9; and class III obesity, with a BMI ≥ 40.0 [5]. Weight gain caused by excess adipose tissue in the abdominal cavity, which increases intra-abdominal pressure and consequently also intravesical pressure, is involved in the genesis of OAB [6,7]. Up to 16 % of women with an increased BMI, especially among the young population, have symptoms referable to OAB [8–10]. After excluding the possibility of a urinary tract infection through urinalysis and the presence of other pathological conditions that may warrant this type of symptomatology [11–15], the diagnosis of OAB was based on patient history and physical examination [16]. Menopause is another * Corresponding author at: Department of Obstetrics and Gynecology, College of Medicine, Kuwait University, 13110 Safat, Kuwait. E-mail address: baydaa.alsannan@ku.edu.kw (B. Alsannan). Contents lists available at ScienceDirect European Journal of Obstetrics & Gynecology and Reproductive Biology journal homepage: www.journals.elsevier.com/european-journal-of-obstetrics-and-gynecology-and- reproductive-biology https://doi.org/10.1016/j.ejogrb.2024.02.010 Received 5 November 2023; Received in revised form 23 January 2024; Accepted 5 February 2024