Is it safe to reduce water intake in the overactive bladder population?: A systematic review.

INTRODUCTION: and Objectives: Overactive bladder (OAB) imposes a significant socioeconomic burden on the healthcare system. It is a commonly held belief that increased fluid intake (eight glasses of water a day) is beneficial for one's health; however, increased fluid intake exacerbates OAB symptoms. Thus, it is imperative that clinicians appropriately educate patients for whom increased water intake may be detrimental (women with OAB), in contrast to patients with comorbidities that necessitate increased water intake (nephrolithiasis). We conducted a systematic review of the literature to determine the potential health advantages of increased water intake and to identify specific subpopulations who need increased hydration. METHODS: A systematic review of published articles from 1972 through 2017 on PubMed and the Cochrane Library was conducted. The data was reviewed independently by two individuals. Studies were included if they explored water intake in relation to risk for a particular disease. RESULTS: Level 1 evidence supports increased fluid intake for patients with nephrolithiasis. There is no available evidence to support increased fluid intake in patients with cardiovascular disease, constipation, venous thromboembolism, headaches, cognitive function or bladder cancer. Dehydration may exacerbate some conditions, specifically chronic constipation and headache intensity. Increased fluid intake may play a role in preventing stroke recurrence; however, not in prevention of primary stroke. CONCLUSIONS: The available reviewed literature suggests no benefit to drinking eight glasses of water a day in patients without nephrolithiasis, and excess fluid intake can exacerbate symptoms of OAB.