title: Is it possible to improve elderly male bladder function by having them drink more water? A randomized trial of effects of increased fluid intake/urine output on male lower urinary tract function.
abstract: OBJECTIVE
  Several animal studies have shown that bladder performance improves as a result of diuresis. Whether increased urine output also has beneficial effects on elderly male bladder function and lower urinary tract symptoms is unknown.
  
  
  METHODS
  We performed a randomized placebo-controlled trial of 141 men, 55 to 75 years of age, with moderate lower urinary tract symptoms. The experimental group drank 1.5 L of extra water daily. The control group consumed one tablespoon of placebo syrup daily. After 6 months, we evaluated bladder contractility, voided volumes, and the severity of lower urinary tract symptoms. The actual increase in water consumption was measured using the deuterium urine dilution method.
  
  
  RESULTS
  Water consumption in the intervention group increased by 359 mL (95% confidence interval [CI] 171 to 548) per 24 hours compared with the control group. At 6 months, no statistically significant effect was found in the maximal flow rate (0.9 mL/s, 95% CI -0.4 to 2.2) compared with placebo. A statistically significant effect was found for bladder pressure (20 cm H2O, 95% CI 6 to 34) and bladder wall stress (1.9 N/cm2, 95% CI 0.3 to 3.5). In addition, it showed that the experimental group had greater maximal (44 mL, 95% CI -1 to 90) and average (26 mL, 95% CI 1 to 51) voided volumes per urination. The subjective effect parameters improved in both groups, but no statistically significant differences were found between the two groups.
  
  
  CONCLUSIONS
  It seems possible to improve some aspects of male bladder function by drinking more water. However, the effects are too small to be clinically relevant.
authors.affiliation: Department of General Practice, Maastricht University, Maastricht, The Netherlands. m.spigt@hag.unimaas.nl
authors.forename: Mark
authors.initials: M
authors.lastname: Spigt
authors.forename: Onno
authors.initials: O
authors.lastname: van Schayck
authors.forename: Paul
authors.initials: P
authors.lastname: Knipschild
authors.forename: Klaas
authors.initials: K
authors.lastname: Westerterp
authors.forename: Cees
authors.initials: C
authors.lastname: van de Beek
authors.forename: Philip
authors.initials: P
authors.lastname: van Kerrebroeck
authors.forename: Johan
authors.initials: J
authors.lastname: Pel
authors.forename: Ron
authors.initials: R
authors.lastname: van Mastrigt
authors.forename: André
authors.initials: A
authors.lastname: Knottnerus
mesh_terms: D000368:Aged; D004326:Drinking; D006801:Humans; D008297:Male; D008875:Middle Aged; D053448:Prostatism / Q000503:physiopathology*; D001743:Urinary Bladder / Q000503:physiopathology*; D014554:Urination