Department of Nutrition and Dietetics, Idaho State University, Meridian, ID 83642, USA.
Int J Environ Res Public Health. 2023 Oct 3;20(19):6879. doi: 10.3390/ijerph20196879.
Clinical guidelines developed by urologic, urogynecologic, and gynecologic associations around the globe include recommendations on nutrition-related lifestyle and behavioral change for bladder storage conditions. This study identified and compared clinical guidelines on three urological conditions (interstitial cystitis/bladder pain syndrome (IC/BPS), overactive bladder, and stress urinary incontinence) affecting adult women.
A three-step process was employed to identify the guidelines. Next, a quality assessment of the guidelines was conducted employing the Appraisal of Guidelines Research and Evaluation (AGREE II) International tool. (3) Results: Twenty-two clinical guidelines, prepared by seventeen groups spanning four continents, met the inclusion criteria. The AGREE II analyses revealed that most of the guideline development processes complied with best practices. The most extensive nutrition recommendations were for women with IC/BPS. Dietary manipulation for the other two storage LUTS primarily focused on the restriction or limitation of specific beverages and/or optimal fluid intake. (4) Conclusion: Clinical guidelines for IC/BPS, overactive bladder, and stress urinary incontinence include nutrition recommendations; however, the extent of dietary manipulation varied by condition. The need to ensure that clinicians are informing patients of the limitations of the evidence supporting those recommendations emerged. Furthermore, given the need to treat nutrition-related comorbid conditions as a strategy to help mitigate these three urological disorders, the value of referral to a dietitian for medical nutrition therapy is apparent.
全球范围内的泌尿科、尿妇科和妇科协会制定的临床指南包括针对膀胱储存状况的与营养相关的生活方式和行为改变的建议。本研究确定并比较了影响成年女性的三种泌尿科疾病（间质性膀胱炎/膀胱疼痛综合征（IC/BPS）、膀胱过度活动症和压力性尿失禁）的临床指南。
采用三步法确定指南。接下来，使用评估指南研究和评估（AGREE II）国际工具对指南进行质量评估。（3）结果：符合纳入标准的临床指南有 22 条，由跨越四大洲的 17 个小组制定。AGREE II 分析表明，大多数指南制定过程符合最佳实践。针对 IC/BPS 女性的营养建议最为广泛。针对其他两种储存性 LUTS 的饮食干预主要集中在限制或限制特定的饮料和/或最佳液体摄入。（4）结论：IC/BPS、膀胱过度活动症和压力性尿失禁的临床指南包括营养建议；然而，饮食干预的程度因病情而异。需要确保临床医生告知患者支持这些建议的证据的局限性。此外，鉴于需要将与营养相关的并存疾病作为减轻这三种泌尿科疾病的策略，向营养师转介医学营养治疗的价值显而易见。
