Are we justified in suggesting change to caffeine, alcohol, and carbonated drink intake in lower urinary tract disease? Report from the ICI‐RS 2015

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.

Section: Discussionmentioning

confidence: 97%

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

Berre

Presse

Morin

et al. 2020

“…It is known that some conditions such as hypertension, diabetes, neurologic diseases, and even cognitive impairment can be related to UI and there is some evidence to support the role of carbonated beverages in the pathogenesis of LUTS . However, there was no evidence to suggest that these factors are more frequently related to nurses than to workers of other professions.…”

Section: Discussionmentioning

confidence: 99%

“…It is known that some conditions such as hypertension, diabetes, neurologic diseases, and even cognitive impairment can be related to UI 40 and there is some evidence to support the role of carbonated beverages in the pathogenesis of LUTS. 41 However, there was no evidence to suggest that these factors are more frequently related to nurses than to workers of other professions. Nurses' behaviors in the workplace, such as poor bladder habits, inadequate liquid consumption, and lifting heavy weights, were associated with LUTS, with one study comparing nurses with secretaries and finding that the nurses presented higher rates, unhealthier habits, and worst QoL.…”

Section: Iciqui-sfmentioning

confidence: 97%

A systematic review of the prevalence, risk factors, and impact of pelvic floor dysfunctions in nurses

Lopes

Vasconcelos

Neto

et al. 2019

Aim To investigate the prevalence, risk factors, and impact of pelvic floor dysfunctions in female nurses. Design A systematic review. Data Sources Searches were conducted in the following five electronic databases: PubMed/Medline, LILACS, SCIELO, Cochrane Library, and CINAHL. There were no period or language limitations. Review Methods Data extraction and synthesis were conducted and the appraisal of the quality of the studies was performed using the Joanna Briggs Institute critical appraisal tool checklist for prevalence data. Results A total of 15 studies were included. The symptoms investigated were lower urinary tract symptoms, including urinary incontinence and its subtypes, sexual dysfunctions, constipation, faecal incontinence, and dual incontinence. Overall, prevalence ranged from 9.9% to 89.6%. Associated factors related to occupational roles were lifting heavy weights and poor bladder habits. Quality of life was significantly worse for nurses with pelvic floor disorders. Conclusion Pelvic floor dysfunctions are very common among female nurses, considerably affecting their quality of life. Additional studies are needed to investigate the impact on work productivity, causal relationships with the occupation and the performance of prevention and treatment interventions directed toward this population.

“…Limiting excess fluid intake and changing the type of fluid is advised in most LUTS guidelines. 70 Less is known about the effect of diet and weight loss. 6 Weight loss will decrease hyperfiltration and diuresis.…”

Section: Intake As a Target Of Nocturia Therapymentioning

confidence: 99%

International Continence Society consensus on the diagnosis and treatment of nocturia

Everaert

Hervé

Bosch

et al. 2019

109

104

Introduction Patients with nocturia have to face many hurdles before being diagnosed and treated properly. The aim of this paper is to: summarize the nocturia patient pathway, explore how nocturia is diagnosed and treated in the real world and use the Delphi method to develop a practical algorithm with a focus on what steps need to be taken before prescribing desmopressin. Methods Evidence comes from existing guidelines (Google, PubMed), International Consultation on Incontinence‐Research Society (ICI‐RS) 2017, prescribing information and a Delphi panel (3 rounds). The International Continence Society initiated this study, the authors represent the ICI‐RS, European Association of Urology, and Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU). Results Diagnostic packages: consensus on, history taking for all causalities, intake diary (fluid, food) and bladder diary, not for its duration. Pelvic (women) or rectal (men) examination, prostate‐specific antigen, serum sodium check (SSC), renal function, endocrine screening: when judged necessary. Timing or empty stomach when SSC is not important. Therapeutic packages: the safe candidates for desmopressin can be phenotyped as no polydipsia, heart/kidney failure, severe leg edema or obstructive sleep apnea syndrome. Lifestyle interventions may be useful. Initiating desmopressin: risk management consensus on three clinical pictures. Follow‐up of desmopressin therapy: there was consensus on SSC day 3 to 7, and at 1 month. Stop therapy if SSC is <130 mmol/L regardless of symptoms. Stop if SSC is 130 to 135 mmol/L with symptoms of hyponatremia. Conclusion A summary of the nocturia patient pathway across different medical specialists is useful in the visualization and phenotyping of patients for diagnosis and therapy. By summarizing basic knowledge of desmopressin, we aim to ease its initiation and shorten the patient journey for nocturia.