TY - JOUR
T1 - Total fluid intake, caffeine, and other bladder irritant avoidance among adults having urinary urgency with and without urgency incontinence
T2 - The Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)
AU - the LURN Study Group
AU - Cameron, Anne P.
AU - Helmuth, Margaret E.
AU - Smith, Abigail R.
AU - Lai, H. Henry
AU - Amundsen, Cindy L.
AU - Kirkali, Ziya
AU - Gillespie, Brenda W.
AU - Yang, Claire C.
AU - Clemens, J. Quentin
N1 - Funding Information:
The following individuals were instrumental in the planning and conduct of this study at each of the participating institutions: Duke University, Durham, North Carolina (DK097780): PIs: Cindy Amundsen, MD, Eric Jelovsek, MD; Co‐Is: Kathryn Flynn, PhD, Jim Hokanson, PhD, Aaron Lentz, MD, David Page, PhD, Nazema Siddiqui, MD, Kevin Weinfurt, PhD, Lisa Wruck, PhD; Study Coordinators: Paige Green, Magaly Guerrero. University of Iowa, Iowa City, IA (DK097772): PIs: Catherine S Bradley, MD, MSCE, Karl Kreder, MD, MBA; Co‐Is: Bradley A. Erickson, MD, MS, Daniel Fick, MD, Vince Magnotta, PhD, Philip Polgreen, MD, MPH; Study Coordinators: Sarah Heady, Chelsea Poesch, Shelly Melton, Jean Walshire. Northwestern University, Chicago, IL (DK097779): PIs: James W. Griffith, PhD, Kimberly Kenton, MD, MS, Brian Helfand, MD, PhD; Co‐Is: Carol Bretschneider, MD, David Cella, PhD, Sarah Collins, MD, Julia Geynisman‐Tan, MD, Alex Glaser, MD, Christina Lewicky‐Gaupp, MD, Margaret Mueller, MD, Devin Boehm; Study Coordinators: Sylwia Clarke, Melissa Marquez, Malgorzata Antoniak, Pooja Talaty, Francesca Moroni, Sophia Kallas. Dr. Helfand and Ms. Talaty are at NorthShore University Health System. University of Michigan Health System, Ann Arbor, MI (DK099932): PI: J. Quentin Clemens, MD, FACS, MSCI; Co‐Is: John DeLancey, MD, Dee Fenner, MD, Rick Harris, MD, Steve Harte, PhD, Anne P. Cameron, MD, Aruna Sarma, PhD, Giulia Lane, MD; Study Coordinators: Linda Drnek, Marissa Moore, Greg Mowatt, Sarah Richardson, Julia Chilimigras, Diana O'Dell. University of Washington, Seattle Washington (DK100011): PI: Claire Yang, MD; Co‐I: Anna Kirby, MD; Study Coordinators: Brenda Vicars, RN, Lauren Daniels. Washington University in St. Louis, St. Louis Missouri (DK100017): PI: H. Henry Lai, MD; Co‐Is: Gerald L. Andriole, MD, Joshua Shimony, MD, PhD, Fuhai Li, PhD; Study Coordinators: Linda Black, Vivien Gardner, Patricia Hayden, Diana Wolff, Aleksandra Klim, RN, MHS, CCRC. Arbor Research Collaborative for Health, Data Coordinating Center (DK099879): PI: Robert Merion, MD, FACS; Co‐Is: Victor Andreev, PhD, DSc, Brenda Gillespie, PhD, Abigail Smith, PhD; Project Manager: Melissa Fava, MPA, PMP; Clinical Monitor: Melissa Sexton, BA, CCRP; Research Analysts: Margaret Helmuth, MA, Jon Wiseman, MS, Jane Liu, MPH, Sarah Mansfield, MS. National Institute of Diabetes and Digestive and Kidney Diseases, Division of Kidney, Urology, and Hematology, Bethesda, MD: Project Scientist: Ziya Kirkali MD; Project Officer: Christopher Mullins PhD; Project Advisor: Julie Barthold, MD. Shauna Leighton, Medical Editor with Arbor Research Collaborative for Health, provided editorial assistance on this manuscript. This is publication number 34 of the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). This study is supported by the National Institute of Diabetes & Digestive & Kidney Diseases through cooperative agreements (grants DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK099879). Research reported in this publication was supported at Northwestern University, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2022 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC.
PY - 2023/1
Y1 - 2023/1
N2 - 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.
AB - 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.
KW - caffeine
KW - fluid intake
KW - urgency
KW - urgency incontinence
KW - voiding diary
UR - http://www.scopus.com/inward/record.url?scp=85140219058&partnerID=8YFLogxK
U2 - 10.1002/nau.25070
DO - 10.1002/nau.25070
M3 - Article
C2 - 36579975
AN - SCOPUS:85140219058
SN - 0733-2467
VL - 42
SP - 213
EP - 220
JO - Neurourology and Urodynamics
JF - Neurourology and Urodynamics
IS - 1
ER -