Does Increasing or Decreasing the Daily Intake of Water/Fluid by Adults Affect Overactive Bladder Symptoms?

BACKGROUND: Modifying fluid intake to decrease overactive bladder (OAB) symptoms, urgency, frequency, and urge urinary incontinence is advocated by health care professionals. OBJECTIVE: This Evidence Based Report Card reviews whether increasing or decreasing the daily intake of water and/or fluids by adults decreases their OAB symptoms. SEARCH STRATEGY: Three reviewers systematically reviewed the literature for studies that evaluated the association or effect of fluid intake on OAB urinary symptoms in adult men and women. A professional librarian performed the literature search, which yielded 260 articles. Following title and abstract reviews, 48 articles were identified for full-text review, and of these, 10 articles met the criteria for inclusion in this review. FINDINGS: Results of studies measuring the effect of fluid intake on the severity of OAB symptoms support that reducing fluid intake is beneficial in reducing OAB symptoms of urge UI, urgency, and frequency. There is evidence that increasing fluid by 25% to 50% could increase daytime frequency; however, studies did not show a significant effect on urgency. Increasing fluid intake is associated with worsening of OAB symptoms in observational studies and shows no difference in symptoms compared to controls in interventional studies. CONCLUSION: WOC nurses should recommend decreased fluid intake for managing OAB symptoms, while ensuring adequate hydration for other health needs (Strength of Recommendations for Treatment statement level 1).