Research Center, Institut universitaire de gériatrie de Montréal, Montreal, Canada.
School of Rehabilitation, Université de Montréal, Montreal, Canada.
Neurourol Urodyn. 2020 Jun;39(5):1217-1233. doi: 10.1002/nau.24344. Epub 2020 Apr 9.
The purpose of this scoping review was to map out the existing literature on caffeine intake and lower urinary tract symptoms (LUTS) in adults.
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.
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.
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.
本系统评价旨在绘制现有的关于成年人咖啡因摄入与下尿路症状(LUTS)的文献图谱。
在本系统评价中,我们检索了截至 2019 年 6 月 MEDLINE、Embase、CINAHL、Cochrane 中心注册数据库、PsycINFO、LILACS、LiSSa、Web of Science 和 Joanna Briggs 研究所电子数据库中所有可用的研究,此外还对手头相关文章的参考文献和灰色文献进行了手工搜索。我们纳入了所有关于干预性研究(评估咖啡因减少对成年人 LUTS 的影响)和观察性研究(评估成年人咖啡因摄入与 LUTS 相关结局之间的关联),并由两名独立评审员评估其方法学质量。
共纳入了 14 项干预性研究和 12 项观察性研究。总体而言,随着咖啡因的减少,尿急发作(证据水平 2,推荐等级 B)和夜间遗尿发作(4,C)减少。观察性研究报告称,咖啡因摄入与 LUTS 相关结局之间的关联不明确。最重要的是,本综述强调了研究人群、咖啡因测量和报告结局的高度异质性。大多数已确定的研究也存在未知或高偏倚风险。
减少咖啡因摄入似乎可以减轻 LUTS。未来关于咖啡因减少干预的研究应针对具有紧迫性和急迫性尿失禁的人群,这些人群的结果最有希望,并应包括咖啡因摄入和 LUTS 的有效和可靠测量。最后,未来的研究还应使用报告指南来确保降低偏倚风险。