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Purported Bladder Irritant Intake in Women With Urgency Urinary Incontinence
Barbara Ha1, Lisa R Yanek2, Bryna J Harrington1
1From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Importance:
Patients with urgency urinary incontinence are often recommended to avoid bladder irritants, but there is a lack of evidence for this.
Objective:
The aim of the study was to compare consumption of purported bladder irritants between women with and without urgency urinary incontinence.
Study Design:
We performed a case-control study of nonpregnant females aged ≥20 years using the National Health and Nutrition Examination Survey, 2007-2020. Cases were defined as participants with moderate, severe, or very severe urgency urinary incontinence without stress urinary incontinence, measured with the Sandvik Incontinence Severity Index. Controls were defined as those without urgency urinary incontinence. The exposures of interest were 6 bladder irritants listed by the National Institute of Diabetes and Digestive and Kidney Diseases: (1) alcohol; (2) spicy foods; (3) chocolate; (4) artificial sweeteners; (5) caffeinated, carbonated, and citrus beverages; and (6) high-acid foods. Weighted multivariable logistic regression analysis was used to determine independent associations between each irritant and urgency urinary incontinence.
Results:
Overall, this study included 651 cases with urgency urinary incontinence (6.8%) and 8,890 controls (93.2%). More cases reported consuming caffeinated, carbonated, and citrus beverages (53.8% vs 47.1%, P = 0.01) and high-acid foods (50.3% vs 44.3%, P = 0.02). In multivariable analysis, the odds of urgency urinary incontinence were increased significantly with intake of caffeinated, carbonated, and citrus beverages (odds ratio 1.37, 95% confidence interval 1.09-1.73) and high-acid foods (odds ratio 1.29, 95% confidence interval 1.03-1.62).
Conclusions:
In this case-control study of community-dwelling adult females, urgency urinary incontinence was associated with consumption of caffeinated, carbonated, and citrus beverages and high-acid foods. Adequately powered prospective trials are needed to further investigate the effects of these foods and beverages on urgency urinary incontinence to guide clinical practice.
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