Purpose Although caffeine consumption is common, and is generally believed to affect bladder function, little is known regarding caffeine intake and incident urinary incontinence. Materials and Methods We conducted a prospective cohort study of 65,176 women without incontinence, aged 37–79 years, in the Nurses’ Health Studies. Incident incontinence was identified from questionnaires, during 4 years of follow-up. Caffeine intake was measured using food frequency questionnaires administered prior to incontinence development. Multivariable-adjusted relative risks for the relation between caffeine intake and incontinence risk were calculated, as well as attributable risks. Results Caffeine was not associated with incontinence monthly or more, but there was a modest, significantly increased risk of incontinence at least weekly among women with the highest versus the lowest intake (RR 1.19, 95% CI 1.06–1.34, comparing >450 vs. <150 mg/day) and a significant trend of increasing risk with increasing intake (p-value for trend=0.01). This risk appeared focused in incident urgency incontinence (RR 1.34, 95% CI 1.00–1.80 comparing >450 vs. <150 mg/day, p-value for trend=0.05), but not stress or mixed incontinence (p-values for trend=0.75 and 0.19, respectively). The attributable risk for urgency incontinence associated with high caffeine intake was 25%. Conclusions Our findings suggest that high caffeine intake, but not lower levels, is associated with a modest increase in incidence of frequent urgency incontinence; one-quarter of these cases among women with the highest level of caffeine consumption might be eliminated if high caffeine intake was eliminated. Confirmation of these findings in other studies is needed before recommendations can be made.

Introduction: We performed a prospective, randomized, double-blinded controlled trial to investigate whether use of DOVERTM Urine Collection Systems with top vent (Tyco Healthcare Group L.P. d/b/a Couidien, Marshfield, MA, USA) top-vented urinary catheters cause fewer epithelial and vascular changes in the bladder mucosa than conventional non-vented catheters. Materials and Methods: Women undergoing a mid-urethral sling were randomized to either placement of a non-vented or top-vented catheter. Primary outcome was change in appearance of the bladder mucosa as graded on a 4-point scale (0–3) after a single drainage event. Secondary outcome was change in red and white blood cell counts per high power field between urinalyses collected intraoperatively and after overnight bladder drainage. A paired T-test with Wilcoxon rank sum was used to compare the grade of mucosal change and the change in cell count. Results: Forty-one women were randomized. The mean change in appearance of the bladder mucosa was significantly greater in the conventional drainage catheter group (2.0 ± 0.23 vs. 0.4 ± 0.11, p < 0.0001). There was no significant difference in the mean cell count intervals on urinalyses between the two groups (1.2 ± 0.34 vs. 0.8 ± 0.34, p = 0.08). Conclusions: By avoiding suction on the bladder mucosa, top-vented urinary catheters cause fewer epithelial and vascular changes in the bladder mucosa compared to conventional catheters.

Objective-We investigated the relation between total fluid intake and incident urinary incontinence in the Nurses' Health Study cohorts.Study Design-We measured daily fluid intake using food frequency questionnaires among 65,167 women, aged 37-79 years, without urinary incontinence at study baseline (2000)(2001). Women reported incontinence incidence on questionnaires during 4 years of follow-up. Multivariable-adjusted hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards models.Results-We found no association between total fluid intake and risk of incident incontinence (hazard ratio 1.04, 95% confidence interval 0.98-1.10 comparing top versus bottom quintile of fluid intake). In analyses of incontinence type, total fluid intake was not associated with risks of incident stress, urgency, or mixed incontinence.Conclusion-No significant risk of incident urinary incontinence was found with higher fluid intake in women. These findings suggest that women should not restrict their fluid intake to prevent incontinence development.