How should patients with an overactive bladder manipulate their fluid intake?

Area of Science:

• Urology
• Nephrology
• Internal Medicine

Background:

• Overactive bladder (OAB) syndrome significantly impacts quality of life.
• Fluid intake is a modifiable factor that may influence OAB symptoms.
• Current management strategies for OAB often involve pharmacotherapy and behavioral interventions.

Purpose of the Study:

• To evaluate the effect of decreasing and increasing fluid intake on OAB symptoms.
• To assess the impact of fluid manipulation on the quality of life in adults with OAB.
• To determine optimal fluid intake strategies for managing OAB.

Main Methods:

• A randomized, prospective, cross-over trial was conducted with adult OAB patients.
• Participants followed a 4-day screening period to establish baseline frequency/volume charts.
• Fluid intake was manipulated by +/- 25% and +/- 50% of baseline values in a cross-over design.

Main Results:

• A 25% reduction in fluid intake significantly decreased OAB symptoms including frequency, urgency, and nocturia.
• Increasing fluid intake by 25% or 50% led to a worsening of daytime frequency.
• While quality of life did not significantly improve overall, subjective improvements in urgency and nocturia were noted with a 25% fluid reduction.

Conclusions:

• Fluid manipulation, particularly a 25% reduction, is an effective, inexpensive, and non-invasive strategy for controlling OAB symptoms.
• Patients experienced significant improvements in urgency, frequency, and nocturia episodes when reducing fluid intake by 25%.
• Major fluid intake alterations (50% increase or decrease) were difficult for patients to maintain and less effective.