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Tang F, Zhang J, Huang R, Zhou H, Yan T, Tang Z, Li Z, Lu Z, Huang S, He Z. The association between wet overactive bladder and consumption of tea, coffee, and caffeine: Results from 2005-2018 National Health and Nutrition Examination Survey. Clin Nutr 2024; 43:1261-1269. [PMID: 38653009 DOI: 10.1016/j.clnu.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 03/02/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND & AIMS Previous studies have reported an inconsistent relationship between overactive bladder (OAB) and the consumption of tea, coffee, and caffeine. Our study aims to determine these associations in a large and nationally representative adult sample. METHODS This cross-sectional study included 15,379 participants from the 2005-2018 US National Health and Nutrition Examination Survey (NHANES) database. The outcome was the risk of wet OAB that was diagnosed when the OAB symptom score was ≥3 with urgent urinary incontinence and excluded other diseases affecting diagnosis. The exposures were the consumption of tea, coffee, and caffeine. Weighted logistic regression models were established to explore these associations by calculating odds ratios (OR) and 95% confidence intervals (CI), as did restricted cubic splines (RCS) used to analyze the nonlinear associations. RESULT Of all the participants (n = 15,379), 2207 had wet OAB. Mean [SE] consumption of tea, total coffee, caffeinated coffee, decaffeinated coffee, and caffeine was 233.6 [15.7] g/day, 364.3 [15.5] g/day, 301.6 [14.9] g/day, 62.7 [7.9] g/day, 175.5 [6.6] mg/day in participants with wet OAB, respectively. In the fully adjusted model, compared to those without tea consumption, the high consumption of tea (>481 g/day) was associated with an increased risk of wet OAB (OR: 1.29; 95%CI: 1.01-1.64). Low decaffeinated coffee (0.001-177.6 g/day) had a negative association with the risk (OR: 0.66; 95%CI: 0.49-0.90). In the RCS analysis, tea consumption showed a positive linear association with the risk of wet OAB, and decaffeinated coffee showed a nonlinear relationship with the risk and had a turning point of 78 g/day in the U-shaped curve between 0 and 285 g/day. Besides, total coffee, caffeinated coffee, and caffeine consumption had no significant association with the risk. Interestingly, in the high tea consumption, participants with high total coffee consumption [>527.35 g/day, OR and 95%CI: 2.14(1.16-3.94)] and low caffeine consumption [0.1-74.0 mg/day, OR and 95%CI: 1.50(1.03-2.17)] were positively associated with the risk of wet OAB. CONCLUSION High tea consumption was associated with the increased risk of wet OAB, especially intake together with high total coffee and low caffeine consumption, but no significant association with the single consumption of total coffee and caffeine. Low decaffeinated coffee was associated with a decreased risk of wet OAB. It is necessary to control tea intake when managing the liquid intake of wet OAB patients.
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Affiliation(s)
- Fucai Tang
- Department of Urology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, 518033, China
| | - Jiahao Zhang
- Department of Urology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, 518033, China
| | - Ruiying Huang
- Guangzhou Medical University, Guangzhou, Guangdong, 511436, China; Medical Exploration and Translation Team, Guangzhou, Guangdong, 510000, China
| | - Haobin Zhou
- Guangzhou Medical University, Guangzhou, Guangdong, 511436, China; Medical Exploration and Translation Team, Guangzhou, Guangdong, 510000, China
| | - Ting Yan
- Guangzhou Medical University, Guangzhou, Guangdong, 511436, China; Medical Exploration and Translation Team, Guangzhou, Guangdong, 510000, China
| | - Zhicheng Tang
- Department of Urology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, 518033, China
| | - Zhibiao Li
- Department of Urology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, 518033, China
| | - Zechao Lu
- Department of Urology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, 518033, China
| | - Shuqiang Huang
- Guangzhou Medical University, Guangzhou, Guangdong, 511436, China; Medical Exploration and Translation Team, Guangzhou, Guangdong, 510000, China
| | - Zhaohui He
- Department of Urology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, 518033, China.
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Esler M. Coffee drinking then and now: research continues to better understand this ubiquitous beverage. Clin Auton Res 2023; 33:613-615. [PMID: 37707721 DOI: 10.1007/s10286-023-00981-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Murray Esler
- Baker Heart and Diabetes Institute, PO Box 6492, Melbourne, VIC, 3004, Australia.
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3
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Andreev VP, Helmuth ME, Smith AR, Zisman A, Cameron AP, DeLancey JOL, Bushman WA. Dynamic analysis of the individual patterns of intakes, voids, and bladder sensations reported in bladder diaries collected in the LURN study. PLoS One 2023; 18:e0284544. [PMID: 37983243 PMCID: PMC10659201 DOI: 10.1371/journal.pone.0284544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023] Open
Abstract
The goal of this study was to develop the novel analytical approach and to perform an in-depth dynamic analysis of individual bladder diaries to inform which behavioral modifications would best reduce lower urinary tract symptoms, such as frequency and urgency. Three-day bladder diaries containing data on timing, volumes, and types of fluid intake, as well as timing, volumes, and bladder sensation at voids were analyzed for 197 participants with lower urinary tract symptoms. A novel dynamic analytic approach to bladder diary time series data was proposed and developed, including intra-subject correlations between time-varying variables: rates of intake, bladder filling rate, and urge growth rate. Grey-box models of bladder filling rate and multivariable linear regression models of urge growth rate were developed for individual diaries. These models revealed that bladder filling rate, rather than urine volume, was the primary determinant of urinary frequency and urgency growth rate in the majority of participants. Simulations performed with the developed models predicted that the most beneficial behavioral modifications to reduce the number of urgency episodes are those that smooth profiles of bladder filling rate, which might include behaviors such as exclusion of caffeine and alcohol and/or other measures, e.g., increasing number and decreasing volumes of intakes.
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Affiliation(s)
- Victor P. Andreev
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States of America
| | - Margaret E. Helmuth
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States of America
| | - Abigail R. Smith
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States of America
| | - Anna Zisman
- Section of Nephrology, University of Chicago, Chicago, IL, United States of America
| | - Anne P. Cameron
- Department of Urology, University of Michigan, Ann Arbor, MI, United States of America
| | - John O. L. DeLancey
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States of America
| | - Wade A. Bushman
- Department of Urology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States of America
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Munguía-Ameca G, Ortega-Cerrilla ME, Herrera-Haro JG, Bárcena-Gama R, Nava-Cuéllar C, Zetina-Córdoba P. Growth Performance, Rumen Fermentation, In Vivo Digestibility, and Meat Quality of Pelibuey Lambs Fed a Diet with Ensiled Coffee Pulp. Animals (Basel) 2023; 13:3462. [PMID: 38003080 PMCID: PMC10668683 DOI: 10.3390/ani13223462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Coffee pulp has been included in ruminant diets; but until now, little has been known about how the addition of ensiled coffee pulp (ECP) affects the growth performance of lambs. This study explores the diet's antioxidant capacity, tannins, and caffeine concentration and its effect on water intake, growth performance, rumen variables, in vivo digestibility, nitrogen balance, and carcass and meat characteristics of lambs fed ECP. Thirty-six male Pelibuey lambs were distributed randomly to one of three treatments (n = 12): without ECP0; diet with 10% ECP10, and diet with 20% ECP20. The diets' antioxidant capacity, tannins, and caffeine concentration were similar (p > 0.05) for all treatments. The diets' antioxidant compounds and the blood serum's antioxidant capacity were affected (p < 0.05). Dry matter and water intake, body-weight gain, and feed conversion were not significant (p > 0.05). No differences (p > 0.05) were found in the rumen variables or the nitrogen balance. However, the in vivo digestibility of crude protein was affected (p < 0.05). Carcass and meat quality were not affected (p > 0.05) by the inclusion of ECP, except temperature and redness (a*) at seven days of storage, respectively. Including up to 20% of ECP in the diet of lambs did not affect the growth performance, rumen variables, or nitrogen balance; however, the antioxidant compounds of the diets, the antioxidant capacity in blood serum, and the in vivo digestibility of crude protein were different. There was an increase in the redness (a*) and lower temperature in the Longissimus dorsi muscle, keeping lightness (L*), yellowness (b*), water-holding capacity, and texture at seven storage days.
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Affiliation(s)
- Graciela Munguía-Ameca
- Programa de Recursos Genéticos y Productividad-Ganadería, Colegio de Postgraduados, Campus Montecillo, Montecillo 56230, Estado de México, Mexico; (G.M.-A.); (J.G.H.-H.); (R.B.-G.)
| | - María Esther Ortega-Cerrilla
- Programa de Recursos Genéticos y Productividad-Ganadería, Colegio de Postgraduados, Campus Montecillo, Montecillo 56230, Estado de México, Mexico; (G.M.-A.); (J.G.H.-H.); (R.B.-G.)
| | - José Guadalupe Herrera-Haro
- Programa de Recursos Genéticos y Productividad-Ganadería, Colegio de Postgraduados, Campus Montecillo, Montecillo 56230, Estado de México, Mexico; (G.M.-A.); (J.G.H.-H.); (R.B.-G.)
| | - Ricardo Bárcena-Gama
- Programa de Recursos Genéticos y Productividad-Ganadería, Colegio de Postgraduados, Campus Montecillo, Montecillo 56230, Estado de México, Mexico; (G.M.-A.); (J.G.H.-H.); (R.B.-G.)
| | - Cuauhtémoc Nava-Cuéllar
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico;
| | - Pedro Zetina-Córdoba
- Programa de Ingeniería Agroindustrial, Universidad Politécnica de Huatusco, Huatusco de Chicuéllar 94100, Veracruz, Mexico
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Olia M, Jafarian A, Mohseni M. Efficacy of Low-Frequency Electroacupuncture on Urinary Retention After Spinal Anesthesia. J Perianesth Nurs 2023; 38:745-747. [PMID: 37162424 DOI: 10.1016/j.jopan.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/27/2022] [Accepted: 01/07/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE This study was designed to evaluate the efficacy of low-frequency electroacupuncture (EA) in the prevention of urinary retention after orthopedic surgery. DESIGN A double-blind placebo-controlled clinical trial. METHODS Eighty patients with spinal anesthesia were randomly allocated into the groups of EA (40 cases) and control (40 cases). In the first group, the EA was applied to four points of SP6, SP9, ST28, and CV2; 4 Hz, retaining for 20 minutes in the postanesthesia care unit (PACU). In the control group, no intervention was applied. The incidence of postoperative urinary retention, incomplete or difficult urination, and the first automatic micturition time since spinal anesthesia were compared between the two groups. FINDINGS The incidence of urinary retention and incomplete urination in the EA group was significantly lower than that in the control group; the time to first urination was shorter in the intervention group than in the control group (P < .05). CONCLUSIONS Electroacupuncture after spinal anesthesia improves bladder function and reduces the need for a urinary catheter and its possible complications.
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Affiliation(s)
- Mina Olia
- Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran
| | - Aliakbar Jafarian
- Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran
| | - Masood Mohseni
- Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran.
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Andreev VP, Helmuth ME, Smith AR, Zisman A, Cameron AP, DeLancey JOL, Bushman WA. Dynamic analysis of the individual patterns of intakes, voids, and bladder sensations reported in bladder diaries collected in the LURN study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.05.23288100. [PMID: 37066258 PMCID: PMC10104230 DOI: 10.1101/2023.04.05.23288100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
The goal of this study was to perform an in-depth dynamic analysis of individual bladder diaries to inform which behavioral modifications would best reduce lower urinary tract symptoms, such as frequency and urgency. Three-day bladder diaries containing data on timing, volumes, and types of fluid intake, as well as timing, volumes, and bladder sensation at voids were analyzed for 197 participants with lower urinary tract symptoms. A novel dynamic analytic approach to bladder diary time series data was proposed and developed, including intra-subject correlations between time-varying variables: rates of intake, bladder filling rate, and urge growth rate. Grey-box models of bladder filling rate and multivariable linear regression models of urge growth rate were developed for individual diaries. These models revealed that bladder filling rate, rather than urine volume, was the primary determinant of urinary frequency and urgency growth rate in the majority of participants. Simulations performed with the developed models predicted that the most beneficial behavioral modifications to reduce the number of urgency episodes are those that smooth profiles of bladder filling rate, which might include behaviors such as exclusion of caffeine and alcohol and/or other measures, e.g., increasing number and decreasing volumes of intakes.
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Affiliation(s)
| | | | | | - Anna Zisman
- Section of Nephrology, University of Chicago, Chicago IL, US
| | - Anne P. Cameron
- Department of Urology, University of Michigan, Ann Arbor MI, US
| | - John O. L. DeLancey
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor MI, US
| | - Wade A. Bushman
- Department of Urology, School of Medicine and Public Health, University of Wisconsin, Madison WI, US
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Cameron AP, Helmuth ME, Smith AR, Lai HH, Amundsen CL, Kirkali Z, Gillespie BW, Yang CC, Clemens JQ. Total fluid intake, caffeine, and other bladder irritant avoidance among adults having urinary urgency with and without urgency incontinence: The Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). Neurourol Urodyn 2023; 42:213-220. [PMID: 36579975 PMCID: PMC9811496 DOI: 10.1002/nau.25070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/30/2022] [Accepted: 10/06/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Caffeine has long been vilified as a cause for urinary urgency incontinence (UUI) along with other potential bladder irritants such as carbonation, alcohol, and acidic juices. The objective of this study was to assess the fluid intake behavior of people with urgency, UUI, and those with lower urinary tract symptoms (LUTS) without UUI or urgency to assess if they avoided certain potential bladder irritants or had different fluid intake. We hypothesized that patients with UUI would avoid caffeine as a self-management method more so than these other two groups. METHODS Treatment-seeking men and women with LUTS in the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) Observational Cohort study completed a baseline 3-day voiding and intake diary. "Complete" diaries had 3 days of data and no missing intake or voided volumes. Beverages with any caffeine, alcohol, carbonation, or acidic juice were identified and the total volume was recorded as well as the type of beverage containing caffeine to calculate the daily caffeine dose. RESULTS Four hundred and ninety-one participants (277 men and 214 women) with a median age of 63 had complete diaries. Urinary urgency was more prevalent in women than men (79% vs. 55%, p < 0.0001) as was UUI (84% vs. 47%, p < 0.0001). Total fluid intake over 3 days was lower among the urgency group versus the nonurgency group (median [interquartile range] 5.2 [4.0-6.8] L vs. 5.7 [4.3-7.0] L, p = 0.028) and the UUI group compared to the urgency without incontinence group were less likely to consume alcohol (26% vs. 37%, p = 0.04). After adjusting for sex, BMI, age, and total intake volume, UUI participants had 54% lower odds of consuming any caffeine (odds ratio = 0.46, 95% confidence interval = 0.22-0.96, p = 0.04) than those without incontinence, but among those that did consume caffeine, no difference in the volume of caffeinated beverages or milligrams of caffeine consumed was detected between those with UUI and those with urgency without incontinence. No difference in carbonation or acidic juice intake was detected between groups. CONCLUSIONS Individuals with urgency consume a lower volume of fluid than those without urgency. UUI participants more often abstain from caffeine, but among those that consume caffeine, the dose is similar to those without UUI. One explanation for these results is that only a subset of individuals with urgency or UUI are caffeine sensitive.
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Affiliation(s)
- Anne P. Cameron
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Abigail R. Smith
- Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA
| | - H. Henry Lai
- Departments of Surgery and Anesthesiology, Division of Urologic Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Cindy L. Amundsen
- Department of Obsterics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA
| | - Ziya Kirkali
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | | | - Claire C. Yang
- Department of Urology, University of Washington, Seattle, Washington, USA
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Enemchukwu EA, Subak LL, Markland A. Barriers and facilitators to overactive bladder therapy adherence. Neurourol Urodyn 2022; 41:1983-1992. [PMID: 35510540 PMCID: PMC11424050 DOI: 10.1002/nau.24936] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/13/2022] [Accepted: 03/23/2022] [Indexed: 12/25/2022]
Abstract
AIMS To provide an overview of the barriers and facilitators to overactive bladder (OAB) therapy initiation and adherence. METHODS A PubMed and Embase literature search was conducted to identify barriers to OAB therapy adherence. RESULTS OAB therapy adherence is associated with improvements in urinary symptoms, and quality of life with reductions in annual costs for OAB-related expenditures. However, adherence rates to behavioral therapies are as low as 32% at 1 year, only 15%-40% of treated patients remain on oral medications at 1 year due to several factors (e.g., inadequate efficacy, tolerability, and cost), and 5%-10% of OAB patients progress to advanced therapies. While some common barriers to therapy adherence are often fixed (e.g., costs, lack of efficacy, time, side effects, treatment fatigue), many are modifiable (e.g., lack of knowledge, poor relationships, negative experiences, poor communication with providers). Patient-centered care may help address some modifiable barriers. Emerging data demonstrate that patient-centered care in the form of treatment navigators improves OAB therapy adherence and progression to advanced therapies in the appropriate patient. CONCLUSIONS There are numerous modifiable barriers to OAB therapy adherence. A patient-centered lens is needed to elicit patient goals, establish realistic treatment expectations, and tailor therapy to improve therapy adherence, optimize outcomes, and reduce healthcare expenditures. Further research is needed to develop and study low-cost, scalable solutions.
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Affiliation(s)
- Ekene A. Enemchukwu
- Department of Urology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Leslee L. Subak
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Alayne Markland
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
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Hsu LN, Hu JC, Chen PY, Lee WC, Chuang YC. Metabolic Syndrome and Overactive Bladder Syndrome May Share Common Pathophysiologies. Biomedicines 2022; 10:1957. [PMID: 36009505 PMCID: PMC9405560 DOI: 10.3390/biomedicines10081957] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/06/2022] [Accepted: 08/09/2022] [Indexed: 11/18/2022] Open
Abstract
Metabolic syndrome (MetS) is defined by a group of cardiovascular risk factors, including impaired glucose tolerance, central obesity, hypertension, and dyslipidemia. Overactive bladder (OAB) syndrome consists of symptoms such as urinary urgency, frequency, and nocturia with or without urge incontinence. The high prevalences of metabolic syndrome (MetS) and overactive bladder (OAB) worldwide affect quality of life and cause profound negative impacts on the social economy. Accumulated evidence suggests that MetS might contribute to the underlying mechanisms for developing OAB, and MetS-associated OAB could be a subtype of OAB. However, how could these two syndromes interact with each other? Based on results of animal studies and observations in epidemiological studies, we summarized the common pathophysiologies existing between MetS and OAB, including autonomic and peripheral neuropathies, chronic ischemia, proinflammatory status, dysregulation of nutrient-sensing pathways (e.g., insulin resistance at the bladder mucosa and excessive succinate intake), and the probable role of dysbiosis. Since the MetS-associated OAB is a subtype of OAB with distinctive pathophysiologies, the regular and non-specific medications, such as antimuscarinics, beta-3 agonist, and botulinum toxin injection, might lead to unsatisfying results. Understanding the pathophysiologies of MetS-associated OAB might benefit future studies exploring novel biomarkers for diagnosis and therapeutic targets on both MetS and OAB.
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Affiliation(s)
- Lin-Nei Hsu
- Department of Urology, An Nan Hospital, China Medical University, Tainan City 833, Taiwan
| | - Ju-Chuan Hu
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 407, Taiwan
| | - Po-Yen Chen
- Division of Urology, Yunlin Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Yunlin 638, Taiwan
| | - Wei-Chia Lee
- Division of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 807, Taiwan
| | - Yao-Chi Chuang
- Division of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 807, Taiwan
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10
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Nguyen LN, Randhawa H, Nadeau G, Cox A, Hickling D, Campeau L, Li J, Welk B, Carlson K. Canadian Urological Association best practice report: Diagnosis and management of nocturia. Can Urol Assoc J 2022; 16:E336-E349. [PMID: 35819914 PMCID: PMC9328849 DOI: 10.5489/cuaj.7970] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Affiliation(s)
- Laura N. Nguyen
- Division of Urology, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Harkanwal Randhawa
- Division of Urology, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Geneviève Nadeau
- Division of Urology, CIUSSS-Capitale Nationale Université Laval, Quebec, QC, Canada
| | - Ashley Cox
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Duane Hickling
- Division of Urology, Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada
| | - Lysanne Campeau
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada
| | - Juliana Li
- Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Blayne Welk
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Kevin Carlson
- Department of Surgery, University of Calgary, Calgary, AB, Canada
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11
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Staack A, Distelberg B, Moldovan C, Belay RE, Sabaté J. The Impact of Caffeine Intake on Mental Health Symptoms in Postmenopausal Females with Overactive Bladder Symptoms: A Randomized, Double-Blind, Placebo-Controlled Trial. J Womens Health (Larchmt) 2022; 31:819-825. [PMID: 35363563 DOI: 10.1089/jwh.2021.0467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Caffeine has been associated with a dose-dependent variety of mental health changes, which have been found to precede or be a complication of overactive bladder (OAB) symptoms after menopause. The current study examines the effects of low and moderate caffeine intake on anxiety, depression, sleep, and stress in postmenopausal females with OAB. Materials and Methods: Eighty-one females were randomized in a prospective, double-blind, placebo-controlled study. Participants were allocated to 200 mg/day caffeine, 400 mg/day caffeine, and placebo capsules for 1 week each in a crossover design and evaluated using validated mental health questionnaires. Symptoms during each treatment phase were measured using Beck Anxiety and Depression Inventory, Insomnia Severity Index, and Perceived Stress Scale. Linear regression models were used to examine the impact of low (200 mg/day) and moderate (400 mg/day) dose of caffeine and placebo on mental health. Results: Fifty-six female participants finished the study. The mean age was 69.2 years (58.0-84.0 years). Two females dropped out during the treatment phase with 400 mg/day caffeine intake due to side effects associated with headaches and nausea. Moderate dose of caffeine showed a small positive effect on mental health, specifically a decrease in anxiety during 7 days of exposure (p < 0.05). Conclusions: Moderate caffeine use may decrease anxiety in postmenopausal patients with underlying OAB, whereas depression, insomnia, and perceived stress were not affected by low-to-moderate caffeine intake. Our results support that counseling efforts on moderate caffeine consumption in postmenopausal patients underline that low-to moderate caffeine intake may be appropriate and possibly beneficial unless contraindicated due to other underlying conditions. Clinical Trials Registration: clinicaltrials.gov (NCT02180048).
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Affiliation(s)
- Andrea Staack
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Brian Distelberg
- Department of Counseling and Family Sciences, School of Behavioral Health, Loma Linda University, Loma Linda, California, USA
| | | | - Ruth E Belay
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Joan Sabaté
- Department of Nutrition, School of Public Health, Loma Linda University, Loma Linda, California, USA
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12
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Rodak K, Kokot I, Kratz EM. Caffeine as a Factor Influencing the Functioning of the Human Body-Friend or Foe? Nutrients 2021; 13:3088. [PMID: 34578966 PMCID: PMC8467199 DOI: 10.3390/nu13093088] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 02/08/2023] Open
Abstract
Nowadays, caffeine is one of the most commonly consumed substances, which presents in many plants and products. It has both positive and negative effects on the human body, and its activity concerns a variety of systems including the central nervous system, immune system, digestive system, respiratory system, urinary tract, etc. These effects are dependent on quantity, the type of product in which caffeine is contained, and also on the individual differences among people (sex, age, diet etc.). The main aim of this review was to collect, present, and analyze the available information including the latest discoveries on the impact of caffeine on human health and the functioning of human body systems, taking into account the role of caffeine in individual disease entities. We present both the positive and negative sides of caffeine consumption and the healing properties of this purine alkaloid in diseases such as asthma, Parkinson's disease, and others, not forgetting about the negative effects of excess caffeine (e.g., in people with hypertension, children, adolescents, and the elderly). In summary, we can conclude, however, that caffeine has a multi-directional influence on various organs of the human body, and because of its anti-oxidative properties, it was, and still is, an interesting topic for research studies including those aimed at developing new therapeutic strategies.
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Affiliation(s)
- Kamil Rodak
- Student Research Club, “Biomarkers in Medical Diagnostics”, Department of Laboratory Diagnostics, Division of Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland
| | - Izabela Kokot
- Department of Laboratory Diagnostics, Division of Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland;
| | - Ewa Maria Kratz
- Department of Laboratory Diagnostics, Division of Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland;
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Monti M, Fischetti M, Santangelo G, Galli V, Clemente F, Giannini A, Tibaldi V, DI Pinto A, Pecorini F, Perniola G, DI Donato V, Benedetti Panici P. Urinary incontinence in women: state of the art and medical treatment. Minerva Obstet Gynecol 2021; 73:135-139. [PMID: 32744453 DOI: 10.23736/s2724-606x.20.04635-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Urinary incontinence, the involuntary loss of urine, is a common condition that affects approximately 50% of adult women. This condition increases with age, affecting 10% to 20% of all women and up to 77% of elderly women residing in nursing homes. EVIDENCE ACQUISITION Systematic data search performed using PubMed/MEDLINE database up to July 20, 2020. Focus was only for English language publications of original studies on urinary incontinence. EVIDENCE SYNTHESIS Given the basis of published evidence and the consensus of European experts, this study provides an updated overview on clinical applications and surgical procedures of urinary incontinence. CONCLUSIONS Urinary incontinence is an underestimated health problem. Patients need an overview of their health condition through a detailed anamnestic collection and physical examination to identify the type of incontinence and offer the best treatment.
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Affiliation(s)
- Marco Monti
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Margherita Fischetti
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Giusi Santangelo
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy -
| | - Valerio Galli
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | | | - Andrea Giannini
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Valentina Tibaldi
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Anna DI Pinto
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Francesco Pecorini
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Giorgia Perniola
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Violante DI Donato
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
| | - Pierluigi Benedetti Panici
- Department of Maternal and Child Health and Urological Sciences, Umberto I Polyclinic, Sapienza University, Rome, Italy
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14
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Le Berre M, Presse N, Morin M, Larouche M, Campeau L, Hu YX, Reid I, Dumoulin C. What do we really know about the role of caffeine on urinary tract symptoms? A scoping review on caffeine consumption and lower urinary tract symptoms in adults. Neurourol Urodyn 2020; 39:1217-1233. [PMID: 32270903 DOI: 10.1002/nau.24344] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 01/20/2023]
Abstract
AIMS The purpose of this scoping review was to map out the existing literature on caffeine intake and lower urinary tract symptoms (LUTS) in adults. METHODS In this scoping review, we searched for all studies available until June 2019 in MEDLINE, Embase, CINAHL, Cochrane Central Register, PsycINFO, LILACS, LiSSa, Web of Science, and Joanna Briggs Institute electronic databases, in addition to a hand search of the bibliographies of all relevant articles and a gray literature search. Both intervention studies on the effects of caffeine reduction in adults with LUTS and observational studies on the association between caffeine intake and LUTS-related outcomes in adults were included and assessed for methodological quality by two independent reviewers. RESULTS Fourteen intervention and 12 observational studies were included. Overall, there was a decrease in urgency episodes (level of evidence 2, grade of recommendation B) and nocturnal enuresis episodes (4, C) with caffeine reduction. Observational studies reported an unclear association between caffeine intake and LUTS-related outcomes. Most importantly, this present review highlighted high heterogeneity in the studied populations, caffeine measures, and reported outcomes. There was also unknown or high risk of bias in most identified studies. CONCLUSIONS Caffeine reduction appears to reduce LUTS. Future studies on caffeine reduction interventions should target populations with urgency and urge urinary incontinence, which show the most promising results, and include valid and reliable measures of caffeine intake and LUTS. Finally, future studies should also use reporting guidelines to ensure lower risk of bias.
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Affiliation(s)
- Mélanie Le Berre
- Research Center, Institut universitaire de gériatrie de Montréal, Montreal, Canada.,School of Rehabilitation, Université de Montréal, Montreal, Canada.,School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
| | - Nancy Presse
- Research Center, Institut universitaire de gériatrie de Montréal, Montreal, Canada.,School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada.,Centre de recherche sur le vieillissement, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, Canada.,Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - Mélanie Morin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada.,Centre de recherche sur le vieillissement, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, Canada.,Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada.,School of Rehabilitation, McGill University, Montreal, Canada
| | - Maryse Larouche
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada.,Research Center, St Mary's Research Centre, Montreal, Canada.,Department of Obstetrics & Gynecology, McGill University, Montreal, Canada
| | - Lysanne Campeau
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada.,Urology Department, Jewish General Hospital, Montreal, Canada.,Department of Surgery/Urology, McGill University, Montreal, Canada
| | - Yu Xin Hu
- Research Center, Institut universitaire de gériatrie de Montréal, Montreal, Canada.,School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada.,School of Rehabilitation, McGill University, Montreal, Canada
| | - Isabelle Reid
- Research Center, Institut universitaire de gériatrie de Montréal, Montreal, Canada.,School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
| | - Chantale Dumoulin
- Research Center, Institut universitaire de gériatrie de Montréal, Montreal, Canada.,School of Rehabilitation, Université de Montréal, Montreal, Canada.,School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
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15
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Badalian SS, Sagayan E, Simonyan H, Minassian VA, Isahakian A. The prevalence of pelvic floor disorders and degree of bother among women attending primary care clinics in Armenia. Eur J Obstet Gynecol Reprod Biol 2020; 246:106-112. [PMID: 32006916 DOI: 10.1016/j.ejogrb.2020.01.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the prevalence of various Pelvic Floor Disorders (PFD) and the degree of symptom bother in a convenience sample of Armenian women in the Republic of Armenia. METHODS Fifty women ages 20-85 years from each Armenian region (Marz) were included in the study. The survey included the validated Armenian version of the Global Pelvic Floor Bother Questionnaire (PFBQ) and general questions on demographics and comorbidities related to these disorders. RESULTS A total of 540 women (90%) attending primary care clinics completed the validated PFBQ questionnaire. Initial analysis showed that the PFBQ score was significantly higher in older women, and those with higher vaginal parity and BMI. Women with prior hysterectomy (37.1+22.4) and prior pelvic prolapse or anti-incontinence surgeries (40.6+21.6) had significantly higher PFBQ scores than women without prior surgeries (18.8+20,0 and 19.4+19.7) and were associated with an increased odds of developing pelvic prolapse symptoms and obstructed defecation. CONCLUSIONS PFD symptoms were observed to be common and significantly correlated with demographic characteristics and self-reported comorbidities in Armenian women. We need to start promoting proper training of physicians in Female Pelvic Medicine and Reconstructive Surgery.
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Affiliation(s)
| | - Elena Sagayan
- Kaiser Permanente Medical Center, Pleasantville, California, USA
| | | | - Vatche A Minassian
- Brigham and Women's Hospital, Harvard Medical School, Massachusetts, USA
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16
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Overactive Bladder in Women: an Update for Primary Care Physicians. CURRENT BLADDER DYSFUNCTION REPORTS 2020. [DOI: 10.1007/s11884-020-00574-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Seasonal Variation of Overactive Bladder Symptoms in Female Patients. Int Neurourol J 2019; 23:334-340. [PMID: 31694352 PMCID: PMC6944789 DOI: 10.5213/inj.1938078.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 01/03/2019] [Indexed: 11/20/2022] Open
Abstract
Purpose To evaluate seasonal variations of overactive bladder (OAB) symptoms in women who visited hospital clinics. Methods Medical records of female patients treated for OAB symptoms from January 2011 to December 2017 were retrospectively reviewed. Patients with pyuria at the first visit, those who did not complete the questionnaire, and those with <3 overactive bladder symptom scores (OABSS) were excluded. Uroflowmetric parameters, 3-day micturition diary, and OABSS were analyzed. Results A total of 582 patients with OAB symptoms who visited the hospital were enrolled in this study. Patients were grouped into 1 of the 3 season groups (cold, intermediate, and hot) depending on the average temperature of the month that the patient first visited the urologic department outpatient clinic. The total OABSS was significantly different between the 3 season groups (cold [7.25±3.20] vs. intermediate [6.24±3.40] vs. hot [5.51±3.20], P=0.001). The proportion of patients who had moderate OAB symptoms (6≤OABSS) was higher in the cold season group (56.2%) than in the other season groups (intermediate, 42.1%; hot, 31.8%; P=0.002). Differences in the number of micturitions (12.12±4.56 vs. 10.95±4.39, P=0.021) and number of urgent urinary incontinence episodes (2.06±0.94 vs. 2.48±0.87, P=0.001) between the cold and hot season groups were also significant. However, differences in the nocturia episode, total daytime voided volume, and mean voided volume between season groups were not significant. Conclusions Different urinary symptoms and uroflowmetric parameters were correlated with seasonal variation. OAB symptoms might be worse in cold season than in other seasons.
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18
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Hao Y, Wang L, Chen H, Hill WG, Robson SC, Zeidel ML, Yu W. Targetable purinergic receptors P2Y12 and A2b antagonistically regulate bladder function. JCI Insight 2019; 4:122112. [PMID: 31434806 DOI: 10.1172/jci.insight.122112] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/26/2019] [Indexed: 12/21/2022] Open
Abstract
Abnormalities in purine availability or purinergic receptor density are commonly seen in patients with lower urinary tract symptoms (LUTS), but the underlying mechanisms relating altered receptor function to LUTS are unknown. Here we provide extensive evidence for the reciprocal interplay of multiple receptors responding to ATP, ADP (adenosine diphosphate), and adenosine, agonists that regulate bladder function significantly. ADP stimulated P2Y12 receptors, causing bladder smooth muscle (BSM) contraction, whereas adenosine signaling through potentially newly defined A2b receptors, actively inhibited BSM purinergic contractility. The modulation of adenylyl cyclase-cAMP signaling via A2b and P2Y12 interaction actively regulated bladder contractility by modulating intracellular calcium levels. KO mice lacking the receptors display diametrically opposed bladder phenotypes, with P2Y12-KO mice exhibiting an underactive bladder (UAB) phenotype with increased bladder capacity and reduced voiding frequency, whereas A2b-KO mice have an overactive bladder (OAB), with decreased capacity and increased voiding frequency. The opposing phenotypes in P2Y12-KO and A2b-KO mice not only resulted from dysregulated BSM contractility, but also from abnormal BSM cell growth. Finally, we demonstrate that i.p. administration of drugs targeting P2Y12 or A2b receptor rescues these abnormal phenotypes in both KO mice. These findings strongly indicate that P2Y12 and A2b receptors are attractive therapeutic targets for human patients with LUTS.
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Affiliation(s)
- Yuan Hao
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Lu Wang
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.,Chongqing University, Chongqing, China
| | - Huan Chen
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Warren G Hill
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Simon C Robson
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Mark L Zeidel
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Weiqun Yu
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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19
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Management of Overactive Bladder in the Young Man. CURRENT BLADDER DYSFUNCTION REPORTS 2019. [DOI: 10.1007/s11884-019-00528-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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20
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Campos RM, Lúcio AC, Lopes MHBDM, Hacad CR, Perissinotto MCR, Glazer HI, D'Ancona CAL. Pelvic floor muscle training alone or in combination with oxybutynin in treatment of nonmonosymptomatic enuresis. A randomized controlled trial with 2-year follow up. EINSTEIN-SAO PAULO 2019; 17:eAO4602. [PMID: 31271608 PMCID: PMC6611091 DOI: 10.31744/einstein_journal/2019ao4602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 12/20/2018] [Indexed: 11/17/2022] Open
Abstract
Objective To compare the results of the standard urotherapy alone and associated with pelvic floor muscle training alone, and in combination with oxybutynin in treatment of nonmonosymptomatic nocturnal enuresis. Methods A total of 38 children aged 5 to 10 years were randomized into three groups: Group I (n=12) that was submitted to standard urotherapy; Group II (n=15), standard urotherapy associated with pelvic floor muscle training; and Group III (n=11), standard urotherapy associated with pelvic floor muscle training and oxybutynin; the treatment lasted 12 weeks. The assessment tools used were playful bladder diary, and a 48-hour bladder diary, before and after treatment. After 2 years, patients were assessed by telephone using a standardized questionnaire. Results The data of children from the three groups were homogeneous at baseline. After 12-week treatment, all children showed improved symptoms and signs of nonmonosymptomatic nocturnal enuresis, but the differences were not significant among the groups. After 2 years, the three groups showed maintenance of treatment results, but no differences among them. Conclusion All treatment modalities were effective regarding improved enuresis and lower urinary tract symptoms, but the sample was not large enough to show differences among groups.
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Affiliation(s)
| | - Adélia Correia Lúcio
- Hospital Universitário Maria Aparecida Pedrossian, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
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21
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Leron E, Weintraub AY, Mastrolia SA, Schwarzman P. Overactive Bladder Syndrome: Evaluation and Management. Curr Urol 2018; 11:117-125. [PMID: 29692690 DOI: 10.1159/000447205] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 09/26/2017] [Indexed: 11/19/2022] Open
Abstract
Overactive bladder (OAB) syndrome is a chronic medical condition which has a major influence on the quality of life in a significant amount of the population. OAB affects performance of daily activities and has an estimated prevalence of 16.5%. Many sufferers do not seek medical help. Moreover, many family physicians and even gynecologists are not familiar with this issue. Usually patients suffer from OAB in advanced age. Nocturia is reported as the most bothersome symptom in the elderly population. The aim of our review was to discuss all aspects of this challenging disorder and suggest tools for assessment and management strategies. Practitioners can easily overlook urinary complains if they not directly queried. We would like to encourage practitioners to give more attention to this issue.
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Affiliation(s)
- Elad Leron
- Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Adi Y Weintraub
- Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Salvatore A Mastrolia
- Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel.,Maternal-Fetal Medicine Unit, Fondazione MBBM, San Gerardo Hospital, School of Medicine, University of Milano Bicocca, Monza, Italy
| | - Polina Schwarzman
- Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
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22
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Reisch R, Rutt R, Dockter M, Sanders S. Overactive Bladder Symptoms in Female Health Profession Students: Bladder Diary Characteristics and Impact of Symptoms on Health-Related Quality of Life. J Womens Health (Larchmt) 2017; 27:156-161. [PMID: 28953429 DOI: 10.1089/jwh.2016.6181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION There is limited information on overactive bladder (OAB) symptoms, their association with bladder irritants, or the effect of OAB on health-related quality of life (HRQoL) in young women. We evaluated these issues in a group of young female health profession students. METHODS All female students (n = 964) attending a university in the Pacific Northwest were recruited via email or an in-person informational meeting to participate in this descriptive cross-sectional study. Outcome measures included the OAB-questionnaire, a 4-day bladder diary, and a demographic questionnaire. OAB was diagnosed if a participant reported an average of at least one episode of urgency per day on the bladder diary. Participant characteristics, bladder diary results, and HRQoL were compared using chi square, Fisher's exact test, and t-tests. RESULTS With a response rate of 21.2%, the average participant age was 25.5 years and 21.7% of participants were identified as having OAB. Participants with OAB consumed more caffeine (mean [standard deviation [SD] 2.0 [1.5] vs. 1.5 [1.2], p = 0.016), more carbonated beverages (mean [SD] 0.5 [0.6] vs. 0.3 [0.5], p = 0.047), more total units of bladder irritants (mean [SD] 3.1 [2.0] vs. 2.1 [1.6], p = 0.002), and had significantly worse HRQoL (p = 0.001) than those without OAB. No differences were found for other parameters measured. CONCLUSION Participants with OAB consumed more bladder irritants than participants without OAB. Future research should address larger groups of young women from different backgrounds, as well as other factors or characteristics that could be associated with OAB.
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Affiliation(s)
- Rebecca Reisch
- 1 School of Physical Therapy, College of Health Professions, Pacific University , Hillsboro, Oregon
| | - Richard Rutt
- 1 School of Physical Therapy, College of Health Professions, Pacific University , Hillsboro, Oregon
| | - Mary Dockter
- 2 Department of Physical Therapy, University of Mary , Bismarck, North Dakota
| | - Sheryl Sanders
- 1 School of Physical Therapy, College of Health Professions, Pacific University , Hillsboro, Oregon
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23
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Turmel N, Hentzen C, Chesnel C, Charlannes A, Le Breton F, Amarenco G. [Food, diet and dietetic in treatment of urinary tract dysfunctions. A review]. Prog Urol 2017; 27:395-401. [PMID: 28576427 DOI: 10.1016/j.purol.2017.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 04/20/2017] [Accepted: 05/02/2017] [Indexed: 11/29/2022]
Abstract
Overactive bladder symptoms (OAB) are frequent and can impact quality of life for these patients. Numerous and various treatments could be proposed in order to improve well-being and quality of life, but all these treatments have side effects and determine for many patients, important care constraints. We present here a review of food and diet in OAB. MATERIAL AND METHODS Literature review from PubMed Medline database and Google scholar to August 2016, without time restriction. Two hundred and ninety-six articles were screened, in English and in French, and finally, 10 were retained. HAS recommandation have been used for level of evidence. RESULTS On the 10 studies included, only two randomised controled trial were included. The first one showed decreases on urgency (by a half) (P=0.02) and on frequency (by a third) (P=0.035), secondary to reduction of caffeine consumption by a half after education [LE2]. The second randomized trial showed significant decreases on the first need to void in urodynamic study after caffeine consumption (170mL vs. 210mL) [LE2]. Feed like bread, chicken or nutrient like vitamin C or D were assessed in cohort or observational studies and appear as protective factors of OAB onset. Instead carbonated drinks may have a negative impact on symptoms, increasing urinary incontinence (OR 1.41 [95 % CI: 1.02-1.95]) [LE2], and there are contradictory results for alcohol consumption. CONCLUSION Diet seems to have an impact on overactive bladder syndrome and particularly caffeine consumption, which increases storage symptoms.
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Affiliation(s)
- N Turmel
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - C Hentzen
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Chesnel
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Charlannes
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - F Le Breton
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - G Amarenco
- Service de neuro-urologie, hôpital Tenon, GRC 01, groupe de recherche clinique en neuro-urologie (GREEN), Sorbonne universités, UPMC université Paris 06, AP-HP, 4, rue de la Chine, 75020 Paris, France
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24
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Temple JL, Bernard C, Lipshultz SE, Czachor JD, Westphal JA, Mestre MA. The Safety of Ingested Caffeine: A Comprehensive Review. Front Psychiatry 2017; 8:80. [PMID: 28603504 PMCID: PMC5445139 DOI: 10.3389/fpsyt.2017.00080] [Citation(s) in RCA: 245] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/24/2017] [Indexed: 12/12/2022] Open
Abstract
Caffeine is the most widely consumed psychoactive drug in the world. Natural sources of caffeine include coffee, tea, and chocolate. Synthetic caffeine is also added to products to promote arousal, alertness, energy, and elevated mood. Over the past decade, the introduction of new caffeine-containing food products, as well as changes in consumption patterns of the more traditional sources of caffeine, has increased scrutiny by health authorities and regulatory bodies about the overall consumption of caffeine and its potential cumulative effects on behavior and physiology. Of particular concern is the rate of caffeine intake among populations potentially vulnerable to the negative effects of caffeine consumption: pregnant and lactating women, children and adolescents, young adults, and people with underlying heart or other health conditions, such as mental illness. Here, we review the research into the safety and safe doses of ingested caffeine in healthy and in vulnerable populations. We report that, for healthy adults, caffeine consumption is relatively safe, but that for some vulnerable populations, caffeine consumption could be harmful, including impairments in cardiovascular function, sleep, and substance use. We also identified several gaps in the literature on which we based recommendations for the future of caffeine research.
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Affiliation(s)
- Jennifer L. Temple
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
| | | | - Steven E. Lipshultz
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Jason D. Czachor
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Joslyn A. Westphal
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Miriam A. Mestre
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
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Madan A, Ray S, Burdick D, Agarwal P. Management of lower urinary tract symptoms in Parkinson's disease in the neurology clinic. Int J Neurosci 2017; 127:1136-1149. [DOI: 10.1080/00207454.2017.1327857] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Arina Madan
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Sudeshna Ray
- Booth Gardner Parkinson's Care Center, Evergreen Neuroscience Institute, Kirkland, WA, USA
| | - Daniel Burdick
- Booth Gardner Parkinson's Care Center, Evergreen Neuroscience Institute, Kirkland, WA, USA
| | - Pinky Agarwal
- Booth Gardner Parkinson's Care Center, Evergreen Neuroscience Institute, Kirkland, WA, USA
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Affiliation(s)
- Alison Bardsley
- Senior lecturer, course director non-medical prescribing, Coventry University
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Affiliation(s)
- Alison Bardsley
- Senior Lecturer, Course Director Non-Medical Prescribing, Coventry University
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Kosilov KV, Loparev SA, Ivanovskaya MA, Kosilova LV. Caffeine as a Probable Factor for Increased Risk of OAB Development in Elderly People. Curr Urol 2016; 9:124-131. [PMID: 27867329 DOI: 10.1159/000442866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 08/11/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This study was conducted to compare overactive bladder (OAB) prevalence among people greater than 60 years of age who intake various doses of caffeine, as well as those who abstain from caffeine. PATIENTS AND METHODS A randomized observational study was carried out in Vladivostok Gerontological Hospital. A total of 1,098 retired people greater than 60 years of age (659 women and 439 men, average age 67.1 years) took part in the study. They were admitted to the in-patient department with the purpose of annual physical examination performed in accordance with the order of the Ministry of Public Health of the Russian Federation. People over age 60, who at the moment of examination were in satisfactory health condition, were included into the study. People in which OAB had been detected or who used to take antimuscarinic were excluded from the study. Assessment tools for examining the patients' lower urinary tract condition were as follows: OAB-q SF, urination diaries, and uroflowmetry. RESULTS In the course of the experiment conducted, we found that 1/3 of people, both men and women greater than 60 years of age, who did not previously seek medical advice due to urination troubles, had symptoms of detrusor overactivity. These symptoms were moderate and did not bother patients too much in most cases (63.4%). It was also found that most patients consumed no more than 300mg caffeine with beverages per day, with 30% and 10% of patients suffering from OAB or severe detrusor overactivity, respectively. At the same time, almost 50% of patients taking more than 300 mg of caffeine per day suffer from OAB. CONCLUSION 48.1% of people over 60 years of age suffering from overactive detrusor symptoms consume greater than 300 mg caffeine daily, which is significantly higher than that of their peers who do not intake excessive amounts of caffeine.
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Affiliation(s)
- Kirill V Kosilov
- School of Humanities, Far Eastern Federal University, Vladivostok, Russia
| | - Sergay A Loparev
- Department of Urology, Urologist of City Polyclinic № 3, Vladivostok, Russia
| | | | - Liliya V Kosilova
- Department of the Functional Methods of Examination, Med. Association № 2 of Vladivostok-sity, Vladivostok, Russia
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Palma IAF, Staack A. Impact of Caffeine on Overactive Bladder Symptoms. CURRENT BLADDER DYSFUNCTION REPORTS 2016. [DOI: 10.1007/s11884-016-0342-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Ostle Z. Assessment, diagnosis and treatment of urinary incontinence in women. ACTA ACUST UNITED AC 2016; 25:84-91. [DOI: 10.12968/bjon.2016.25.2.84] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Zoe Ostle
- Specialist Nurse, Bladder and Bowel Service, South Tyneside NHS Foundation Trust
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Staack A, Distelberg B, Schlaifer A, Sabaté J. Prospective study on the effects of regular and decaffeinated coffee on urinary symptoms in young and healthy volunteers. Neurourol Urodyn 2015; 36:432-437. [PMID: 26703981 DOI: 10.1002/nau.22949] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 11/30/2015] [Indexed: 11/11/2022]
Abstract
AIMS Coffee reduction has been a strategy to prevent urinary symptoms with conflicting evidence. We aimed to study the effects of regular and decaffeinated coffee on urinary symptoms among low and frequent coffee users, who were young and healthy. METHODS We conducted a double-blinded parallel study on subjects, who were restricted from consuming caffeinated items outside the study. After subjects completed 5 days of caffeine abstinence they consumed regular coffee (450 mg/d caffeine content) or decaffeinated coffee (12 mg/d caffeine content) for 5 days. Previous caffeine use and urinary symptoms were assessed by a diet survey, urogenital distress inventory, and interstitial cystitis problem and symptom indices (ICPI, ICSI). RESULTS Forty nine subjects completed the study. When assessing the submeasures "frequency" and "urgency" on ICPI and ICSI subjects drinking coffee reported a significant increase in urgency (P < 0.05) and frequency (P < 0.05), whereas subjects drinking decaffeinated coffee experienced no difference in those submeasures in comparison to no caffeine intake. However, previous "low coffee users" experienced the largest increase of urinary symptoms, whereas previous "frequent coffee users" showed fewer symptoms when exposed to regular coffee. CONCLUSIONS The study suggests that avoiding high-dosage coffee consumption prevents urgency and frequency, which supports recommendations to limit caffeinated beverages. The study differentiates between subjects having a history of low and frequent coffee use. Subjects, who are not used to regular coffee consumption, seem to be more vulnerable to the effects of coffee on urinary symptoms. Better understanding of the effects of coffee on urinary symptoms may improve patients counseling. Neurourol. Neurourol. Urodynam. 36:432-437, 2017. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Andrea Staack
- Department of Urology, Loma Linda University Medical Center, Loma Linda University, Loma Linda, California
| | - Brian Distelberg
- Department of Counseling and Family Sciences, School of Behavioral Health, Loma Linda University, Loma Linda, California
| | - Amy Schlaifer
- Department of Urology, Loma Linda University Medical Center, Loma Linda University, Loma Linda, California
| | - Joan Sabaté
- Department of Nutrition, School of Public Health, Loma Linda University, Loma Linda, California
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Electroacupuncture for bladder function recovery in patients undergoing spinal anesthesia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:892619. [PMID: 25610486 PMCID: PMC4290146 DOI: 10.1155/2014/892619] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 12/10/2014] [Indexed: 02/07/2023]
Abstract
Purpose. To determine the efficacy of electroacupuncture on recovering postanesthetic bladder function. Materials and Methods. Sixty-one patients undergoing spinal anaesthesia were recruited and allocated into electroacupuncture or control group randomly. Patients in electroacupuncture group received electroacupuncture therapy whereas ones in control group were not given any intervention. Primary endpoint was incidence of bladder overdistension and postoperative urinary retention. Secondary endpoints included time to spontaneous micturition, voided volume, and adverse events. Results. All patients (31 in electroacupuncture group and 30 in control group) completed the evaluation. During postoperative follow-up, patients in electroacupuncture group presented a significant lower proportion of bladder overdistension than counterparts in control group (16.1% versus 53.3%, P < 0.01). However, no significant difference was found in incidence of postoperative urinary retention between the two groups (0% versus 6.7%, P > 0.05). Furthermore, a shorter time to spontaneous micturition was found in electroacupuncture group compared to control group (228 min versus 313 min, P < 0.001), whereas urine volume and adverse events had no significant difference between the two groups. Conclusions. Electroacupuncture reduced the proportion of bladder overdistension and shortened the time to spontaneous micturition in patients undergoing spinal anesthesia. Electroacupuncture may be a therapeutic strategy for postanesthetic bladder dysfunction.
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Cho YS, Ko IG, Kim SE, Hwan L, Shin MS, Kim CJ, Kim SH, Jin JJ, Chung JY, Kim KH. Caffeine enhances micturition through neuronal activation in micturition centers. Mol Med Rep 2014; 10:2931-6. [PMID: 25323389 DOI: 10.3892/mmr.2014.2646] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 05/28/2014] [Indexed: 11/06/2022] Open
Abstract
Caffeine may promote incontinence through its diuretic effect, particularly in individuals with underlying detrusor overactivity, in addition to increasing muscle contraction of the bladder smooth muscle. Caffeine may also affect bladder function via central micturition centers, including the medial preoptic area, ventrolateral periaqueductal gray, and pontine micturition center. However, the biochemical mechanisms of caffeine in central micturition centers affecting bladder function remain unclear. In the present study, the effects of caffeine on the central micturition reflex were investigated by measuring the degree of neuronal activation, and by quantifying nerve growth factor (NGF) expression in rats. Following caffeine administration for 14 days, a urodynamic study was performed to assess the changes to bladder function. Subsequently, immunohistochemical staining to identify the expression of c‑Fos and NGF in the central micturition areas was performed. Ingestion of caffeine increased bladder smooth muscle contraction pressure and time as determined by cystometry. Expression levels of c‑Fos and NGF in all central micturition areas were significantly increased following the administration of caffeine. The effects on contraction pressure and time were the most potent and expression levels of c‑Fos and NGF were greatest at the lowest dose of caffeine. These results suggest that caffeine facilitates bladder instability through enhancing neuronal activation in the central micturition areas.
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Affiliation(s)
- Young-Sam Cho
- Department of Urology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 110‑746, Republic of Korea
| | - Il-Gyu Ko
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 130‑701, Republic of Korea
| | - Sung-Eun Kim
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 130‑701, Republic of Korea
| | - Lakkyong Hwan
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 130‑701, Republic of Korea
| | - Mal-Soon Shin
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 130‑701, Republic of Korea
| | - Chang-Ju Kim
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul 130‑701, Republic of Korea
| | - Sang-Hoon Kim
- Department of Physical Education, Graduate School of Education, Sangmyung University, Seoul 110‑743, Republic of Korea
| | - Jun-Jang Jin
- Department of Physical Activity Design, College of Science, Hanseo University, Seosan 356‑706, Republic of Korea
| | - Jun-Young Chung
- Department of Anesthesiology and Pain Medicine, Gangdong Kyung Hee Hospital, College of Medicine, Kyung Hee University, Seoul 134‑727, Republic of Korea
| | - Khae-Hawn Kim
- Department of Urology, Gachon University Gil Medical Center, Incheon 405‑760, Republic of Korea
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Managing therapeutic competition in patients with heart failure, lower urinary tract symptoms and incontinence. Drugs Aging 2014; 31:93-101. [PMID: 24357134 PMCID: PMC3907694 DOI: 10.1007/s40266-013-0145-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Up to 50 % of heart failure patients suffer from lower urinary tract symptoms. Urinary incontinence has been associated with worse functional status in patients with heart failure, occurring three times more frequently in patients with New York Heart Association Class III and IV symptoms compared with those with milder disease. The association between heart failure and urinary symptoms may be directly attributable to worsening heart failure pathophysiology; however, medications used to treat heart failure may also indirectly provoke or exacerbate urinary symptoms. This type of drug–disease interaction, in which the treatment for heart failure precipitates incontinence, and removal of medications to relieve incontinence worsens heart failure, can be termed therapeutic competition. The mechanisms by which heart failure medication such as diuretics, angiotensin-converting enzyme (ACE) inhibitors and β-blockers aggravate lower urinary tract symptoms are discussed. Initiation of a prescribing cascade, whereby antimuscarinic agents or β3-agonists are added to treat symptoms of urinary urgency and incontinence, is best avoided. Recommendations and practical tips are provided that outline more judicious management of heart failure patients with lower urinary tract symptoms. Compelling strategies to improve urinary outcomes include titrating diuretics, switching ACE inhibitors, treating lower urinary tract infections, appropriate fluid management, daily weighing, and uptake of pelvic floor muscle exercises.
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The Effect of Caffeinated Versus Decaffeinated Drinks on Overactive Bladder. J Wound Ostomy Continence Nurs 2014; 41:371-8. [DOI: 10.1097/won.0000000000000040] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Overactive bladder (OAB) is a symptom complex of urinary frequency, nocturia and urgency with or without urgency incontinence that adversely impacts patient's quality of life. Conservative management begins in the outpatient clinic, often with significant improvement and patient satisfaction. In this review we will discuss the evaluation of OAB and review treatment options focusing on behavioral modification, medical therapy, and neuromodulation. These treatment options are offered in a stepwise fashion, remembering that more than one may be needed and can be used concomitantly.
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Abstract
PURPOSE OF REVIEW This review examines the evidence to date, analyzes specific risk factors and assesses the ability to prevent urinary incontinence in women, while providing clinical recommendations. More extraordinary risk factors such as ethnicity and race, mixed and fecal incontinence, iatrogenic and neurogenic factors should be discussed in a follow-up report. RECENT FINDINGS Studies have revealed that certain factors place women at risk for developing urinary incontinence, including age, obesity, diabetes, pregnancy and delivery, high-impact physical exercise factors and estrogen deficiency. SUMMARY Healthcare providers should screen women who are at risk for developing urinary incontinence and institute specific interventions, specifically behavioral and even rehabilitative techniques, to prevent this prevalent and distressing condition.
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Abstract
Urine differs greatly in ion and solute composition from plasma and contains harmful and noxious substances that must be stored for hours and then eliminated when it is socially convenient to do so. The urinary tract that handles this output is composed of a series of pressurizable muscular compartments separated by sphincteric structures. With neural input, these structures coordinate the delivery, collection, and, ultimately, expulsion of urine. Despite large osmotic and chemical gradients in this waste fluid, the bladder maintains a highly impermeable surface in the face of a physically demanding biomechanical environment, which mandates recurring cycles of surface area expansion and increased wall tension during filling, followed by rapid wall compression during voiding. Afferent neuronal inflow from mucosa and submucosa communicates sensory information about bladder fullness, and voiding is initiated consciously through coordinated central and spinal efferent outflow to the detrusor, trigonal internal sphincter, and external urethral sphincter after periods of relative quiescence. Provocative new findings suggest that in some cases, lower urinary tract symptoms, such as incontinence, urgency, frequency, overactivity, and pain may be viewed as a consequence of urothelial defects (either urothelial barrier breakdown or inappropriate signaling from urothelial cells to underlying sensory afferents and potentially interstitial cells). This review describes the physiologic and anatomic mechanisms by which urine is moved from the kidney to the bladder, stored, and then released. Relevant clinical examples of urinary tract dysfunction are also discussed.
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Affiliation(s)
- Warren G Hill
- Laboratory of Voiding Dysfunction, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
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40
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Abstract
BACKGROUND Review of data on complications following joint replacement surgery revealed that urinary retention is a potential cause of increased morbidity. Repeat catheterizations, urinary tract infections, and possible infection of the prosthetic joint can result in a prolonged hospital length of stay. This study examined the effect of warm caffeinated coffee on a patient's ability to spontaneously void after indwelling catheter removal and the correlation between bladder volume and the ability to void spontaneously. METHODS This was a randomized, controlled, pilot study of subjects who underwent unilateral total knee arthroplasty or total hip arthroplasty. The indwelling catheter was removed postoperative day 1. If unable to void within 3 hours, participants were randomized into a control group and an intervention group. At scheduled intervals, the control group consumed 8 oz of warm water and the intervention group consumed 8 oz of caffeinated coffee. RESULTS Thirty subjects were randomized; 14 were randomized to the water group and 16 to the caffeine group. Twenty-four subjects spontaneously voided after ingestion of fluid and six required straight catheterization. Of these six, five of the subjects had ingested water and one subject had ingested coffee. For those who spontaneously voided, there was not a significant difference between the caffeine group and the water group. There was a significant difference between caffeine ingestion and the volume of the void. DISCUSSION Findings from this study suggest that ingestion of caffeine after removal of an indwelling urinary catheter in the postoperative patient may increase the amount of voiding volumes initially, therefore avoiding the need for straight catheterization. To accurately assess this, extending the study into postoperative day 2 would allow us to evaluate whether lower voiding volumes lead to the need for catheterization.
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Newman DK, Wein AJ. Office-Based Behavioral Therapy for Management of Incontinence and Other Pelvic Disorders. Urol Clin North Am 2013; 40:613-35. [DOI: 10.1016/j.ucl.2013.07.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Ruxton CHS. The suitability of caffeinated drinks for children: a systematic review of randomised controlled trials, observational studies and expert panel guidelines. J Hum Nutr Diet 2013; 27:342-57. [PMID: 25099503 DOI: 10.1111/jhn.12172] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The increased availability of caffeinated drinks raises questions about the level of caffeine that is appropriate for children, as well as the benefits and risks associated with their consumption. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this systematic review evaluates evidence from randomised controlled trials investigating the effects of caffeine on cognition, behaviour, mood and exercise performance in children. Observational studies and expert panel guidelines are also discussed. RESULTS One hundred and nine studies were found, with 11 randomised controlled trials and 13 observational studies meeting the criteria. High caffeine intakes (e.g. >5 mg kg(-1) body weight day(-1)) were associated with an increased risk of anxiety and withdrawal symptoms. However, smaller amounts were not linked with such effects and may benefit cognitive function and sports performance based on adult studies. The evidence suggests that children and adolescents should limit daily caffeine consumption to 2.5 mg kg(-1) body weight day(-1), equating to one or two cups of tea or one small cup of coffee. Lower contributors of caffeine, such as tea, may be more appropriate for children because they contribute to daily fluid intakes and provide flavonoids. By contrast, caffeinated soft drinks may be less suitable options for children as a result of their acidity, higher caffeine content, presence of added sugar (in some cases) and absence of bioactive compounds. CONCLUSIONS More studies are needed to determine the intakes that represent a risk and whether there may be benefits for alertness and sports performance with moderate intakes of caffeine.
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Increased fluid intake is associated with bothersome bowel symptoms among women with urinary incontinence. Female Pelvic Med Reconstr Surg 2013; 19:152-6. [PMID: 23611933 DOI: 10.1097/spv.0b013e318288ac08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the association between the type and volume of fluid intake and bowel symptoms in women with urinary incontinence. We hypothesize that a lower volume of fluid intake would be associated with greater straining with bowel movements in women with urinary incontinence. METHODS We performed a cross-sectional study of 256 women presenting with complaints of urinary incontinence from 2009 to 2010. Data on fluid intake, fluid intake behavior, urinary and bowel symptoms were collected using validated questionnaires. The relationship between quartiles of total daily fluid intake and bowel symptoms was analyzed. RESULTS The behavior of restricting fluid intake was reported by 32% of the women. Increasing quartiles of total daily fluid intake was significantly associated with greater bother from straining with bowel movements (P = 0.04). Women with no bother from straining with bowel movements had significantly lower median daily fluid intake (2839 mL) than women with quite a bit of bother (3312 mL; P = 0.01). The association between the volume of fluid intake and straining with bowel movements persisted after controlling for age, body mass index, history of prolapse or incontinence surgery, and stage of prolapse (P < 0.05). There was no association between caffeinated fluid intake and any bowel symptom or between the behavior of restricting fluid intake and any bowel symptom. CONCLUSION In women with urinary incontinence, higher volume of total fluid intake is reported by women with greater straining with bowel movements. The behavior of fluid restriction is not associated with bothersome bowel symptoms.
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Maserejian NN, Wager CG, Giovannucci EL, Curto TM, McVary KT, McKinlay JB. Intake of caffeinated, carbonated, or citrus beverage types and development of lower urinary tract symptoms in men and women. Am J Epidemiol 2013; 177:1399-410. [PMID: 23722012 DOI: 10.1093/aje/kws411] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Evidence to substantiate recommendations for restriction of caffeinated or acidic beverages as self-management for lower urinary tract symptoms (LUTS) is limited. We examined longitudinal and acute associations between beverage intake and LUTS in the Boston Area Community Health (BACH) cohort (n = 4,144) between 2002 and 2010. Multivariable models tested associations between baseline intakes and progression of LUTS at 5-year follow-up, between follow-up intakes and International Prostate Symptom Scores at follow-up, and between 5-year intake changes and LUTS progression. Greater coffee or total caffeine intake at baseline increased the odds of LUTS progression in men (coffee: >2 cups/day vs. none, odds ratio = 2.09, 95% confidence interval: 1.29, 3.40, P-trend = 0.01; caffeine: P-trend < 0.001), particularly storage symptoms. Women who increased coffee intake by at least 2 servings/day during follow-up (compared with categories of decreased or unchanged intakes) had 64% higher odds of progression of urgency (P = 0.003). Women with recently increased soda intake, particularly caffeinated diet soda, had higher symptom scores, urgency, and LUTS progression. Citrus juice intake was associated with 50% lower odds of LUTS progression in men (P = 0.02). Findings support recommendations to limit caffeinated beverage intake for LUTS, and in men, they suggest benefits of citrus juice consumption. Further clinical research is warranted, particularly of the precise role of sodas containing artificial sweeteners in bladder sensations and urological function.
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Affiliation(s)
- Nancy N Maserejian
- Department of Epidemiology, New England Research Institutes, Watertown, Massachusetts 02472, USA.
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Wen JG, Li JS, Wang ZM, Huang CX, Shang XP, Su ZQ, Lu YT, Suo ZH, Wang Y, Qin GJ, Zhang WX, Heesakkers JP. The prevalence and risk factors of OAB in middle-aged and old people in China. Neurourol Urodyn 2013; 33:387-91. [PMID: 23765684 DOI: 10.1002/nau.22429] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 04/17/2013] [Indexed: 11/12/2022]
Affiliation(s)
- Jian G. Wen
- Urodynamic Center; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
- Institute of Clinical Medicine; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Jin S. Li
- Urodynamic Center; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Zhi M. Wang
- Department of Endocrinology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Chen X. Huang
- Urodynamic Center; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Xiao P. Shang
- Medical Record Department; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Zhi Q. Su
- Urodynamic Center; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Yu T. Lu
- Urodynamic Center; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Zhen H. Suo
- Institute of Clinical Medicine; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Yan Wang
- Urodynamic Center; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Gui J. Qin
- Department of Endocrinology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - Wei X. Zhang
- Department of Urology; The First Affiliated Hospital of Zhengzhou University; Zhengzhou China
| | - John P. Heesakkers
- Department of Urology; Radboud University, Nijmegen Medical Centre; Nijmegen The Netherlands
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Burgio KL, Newman DK, Rosenberg MT, Sampselle C. Impact of behaviour and lifestyle on bladder health. Int J Clin Pract 2013; 67:495-504. [PMID: 23679903 DOI: 10.1111/ijcp.12143] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 01/18/2013] [Indexed: 01/22/2023] Open
Abstract
Bladder conditions, including UTI, UI, and bladder cancer, are highly prevalent and affect a wide range of populations. There are a variety of modifiable behavioral and lifestyle factors that influence bladder health. Some factors, such as smoking and obesity, increase the risk or severity of bladder conditions, whereas other factors, such as pelvic floor muscle exercise, are protective. Although clinical practice may be assumed to be the most appropriate ground for education on behavioral and lifestyle factors that influence bladder health, it is also crucial to extend these messages into the general population through public health interventions to reach those who have not yet developed bladder conditions and to maximize the prevention impact of these behaviors. Appropriate changes in these factors have the potential for an enormous impact on bladder health if implemented on a population-based level.
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Affiliation(s)
- K L Burgio
- Department of Veterans Affairs Medical Center, Birmingham, AL 35233, USA.
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Davis NJ, Vaughan CP, Johnson TM, Goode PS, Burgio KL, Redden DT, Markland AD. Caffeine intake and its association with urinary incontinence in United States men: results from National Health and Nutrition Examination Surveys 2005-2006 and 2007-2008. J Urol 2012; 189:2170-4. [PMID: 23276513 DOI: 10.1016/j.juro.2012.12.061] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2012] [Indexed: 01/11/2023]
Abstract
PURPOSE Epidemiological studies in women have revealed an association between caffeine intake and urinary incontinence, although evidence among men is limited. Therefore, we evaluated the association between caffeine intake and urinary incontinence in United States men. MATERIALS AND METHODS Data were used from male NHANES (National Health and Nutrition Examination Surveys) 2005-2006 and 2007-2008 participants. Urinary incontinence was defined using a standard questionnaire with Incontinence Severity Index scores 3 or greater categorized as moderate to severe. Structured dietary recall was used to determine caffeine consumption (mg per day), water intake (gm per day) and total dietary moisture (gm per day). Stepwise multivariable logistic regression models were used to assess the association between caffeine intake at or above the 75th and 90th percentiles and moderate to severe urinary incontinence, controlling for potential confounders, urinary incontinence risk factors and prostate conditions in men age 40 years or older. RESULTS Of the 5,297 men 3,960 (75%) were 20 years old or older with complete data. Among these men the prevalence of any urinary incontinence was 12.9% and moderate to severe urinary incontinence was 4.4%. Mean caffeine intake was 169 mg per day. Caffeine intake at the upper 75th percentile (234 mg or more daily) and 90th percentile (392 mg or more per day) was significantly associated with having moderate to severe urinary incontinence (1.72, 95% 1.18-2.49 and 2.08, 95% 1.15-3.77, respectively). In addition, after adjusting for prostate conditions, the effect size for the association between caffeine intake and moderate to severe urinary incontinence remained. CONCLUSIONS Caffeine consumption equivalent to approximately 2 cups of coffee daily (250 mg) is significantly associated with moderate to severe urinary incontinence in United States men. Our findings support the further study of caffeine modification in men with urinary incontinence.
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Affiliation(s)
- Nicole J Davis
- Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA.
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48
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Abstract
OBJECTIVE To estimate the association between long-term caffeine intake and risk of urinary incontinence (UI) progression over 2 years among women with moderate UI. METHODS We conducted a prospective cohort study in 21,564 women with moderate UI enrolled in the Nurses' Health Study and Nurses' Health Study II. Incontinence progression was identified from questionnaires during 2 years of follow-up. Baseline caffeine intake (ie, average intake during the previous year) and change in caffeine intake during the 4 years before baseline were measured using food frequency questionnaires. Odds ratios (ORs) for incontinence progression according to caffeine intake were calculated for each cohort separately, and then for both cohorts combined. RESULTS The percentage of women with UI progression was similar across categories of baseline level of caffeine intake and change in caffeine intake before baseline. For example, percentages were 21% compared with 22% comparing 450 mg or more to less than 150 mg of caffeine per day (adjusted OR 0.87, 95% confidence interval 0.70-1.08). Comparing women with increased caffeine intake to those with stable caffeine intake, percentages with progression were 22% compared with 20% (OR 1.08, 95% confidence interval 0.95-1.22). Results were similar in separate analyses of urge and stress UI. CONCLUSION Long-term caffeine intake over 1 year was not associated with risk of UI progression over 2 years among women with moderate incontinence, although we could not examine acute effects of caffeine. Improved understanding of the effect of caffeine on the bladder is needed to better-advise women with incontinence about caffeine intake. LEVEL OF EVIDENCE II.
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49
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Abstract
A panel of experts in urology, urogynecology, nursing, and behavioral therapy convened in 2010 to discuss the importance of a healthy bladder on overall health. They determined that a consensus statement was necessary to raise awareness among the general public, healthcare providers, payors, and policymakers, with the goals of minimizing the impact of poor bladder health and stimulating primary prevention of bladder conditions. In this statement, 'healthy' bladder function is described, as well as internal and external factors that influence bladder health. It is suggested that primary prevention strategies should be aimed at providing education regarding normal lower urinary tract structures and functioning to the public, including patients and healthcare providers. This education may promote the achievement of optimal bladder health by increasing healthy bladder habits and behaviors, awareness of risk factors, healthcare seeking, and clinician engagement and reducing stigma and other barriers to treatment. Promoting optimal bladder health may reduce the personal, societal and economic impact of bladder conditions, including anxiety and depression and costs associated with conditions or diseases and their treatment. While adopting healthy bladder habits and behaviors and behaviors may improve or maintain bladder health, it is important to recognize that certain symptoms may indicate the presence of conditions that require medical attention; many bladder conditions are treatable with a range of options for most bladder conditions. Lastly, the authors propose clinical directives based on persuasive and convergent research to improve and maintain bladder health. The authors hope that this statement will lead to promotion and achievement of optimal bladder health, which may improve overall health and help minimize the effects of bladder conditions on the public, healthcare professionals, educators, employers, and payors. The advisors are in consensus regarding the recommendations for improving and maintaining bladder health presented herein.
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Affiliation(s)
- E S Lukacz
- University of California, San Diego, San Diego, CA 92037, USA.
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