DIURETICS AND URINARY-INCONTINENCE IN COMMUNITY-DWELLING WOMEN

The relationship between diuretics and involuntary urine loss is poorly understood. This study presents data on 130 community‐dwelling women with urinary incontinence. Forty‐five of these women took diuretics and 85 did not. These groups were compared with regard to clinical and urodynamic characteristics and severity of urinary incontinence and of diurnal and nocturnal micturition frequency. Subjects on diuretics were heavier (P<0.01), had higher systolic blood pressure (P<0.001), and had a higher prevalence of cardiovascular disease (P<0.001) and diabetes (P<0.001). In addition, they used cardiovascular medications more often (P<0.001) and had been treated for incontinence previously more frequently (P<0.001). Urodynamic variables showed essentially no significant differences other than the volume voided during uroflowmetry, with subjects on diuretics voiding significantly smaller volumes than subject not taking such drugs (P<0.05). Those on diuretics had significantly more incontinent episodes (P<0.01) and diurnal urinary frequency (P = 0.001). In addition, those subjects on diuretics who had bladder instability lost significantly larger quantities of fluid during testing (P<0.05) and had more episodes of nocturia (P<0.01). Although some findings can be explained by an increased diuresis, others cannot. A local pharmacologic effect is thought unlikely. Changes in sensitivity threshold due to habit, or behavior is considered possible. Diuretics and/or conditions associated with their use seem to influence the severity of the syndrome of urinary incontinence. Copyright © 1990 Wiley‐Liss, Inc., A Wiley Company