The Impact of Dry Mouth on Fluid Intake and Overactive Bladder Symptoms in Women taking Fesoterodine

To investigate the long-term relationships between dry mouth, fluid intake and overactive bladder symptoms in women undergoing treatment with fesoterodine. We hypothesize that women who experience dry mouth will increase their fluid intake and worsen their urinary symptoms.

We conducted a prospective ancillary study to a 9 month open-label trial of fesoterodine for women with urgency urinary incontinence. Fluid intake was measured and compared according to reported dry mouth. Multivariable analysis was used to study the interaction between dry mouth, fluid intake and urinary symptoms.

During the study, women without dry mouth (n=407) significantly reduced their fluid intake (mean decrease of 172. 1 mL, median decrease of 118. 3 mL, p= 0. 02), while women with dry mouth (n=91) did not (mean decrease of 95. 8 mL, median decrease of 118. 3 mL, p=0. 54). On univariable analysis, a greater proportion of women who experienced dry mouth reported improvement in their urinary symptoms compared to women without dry mouth (60. 5% versus 47. 2%, p=0. 03). On multivariable analysis, Black/ African American women were less likely to report dry mouth (OR 0. 4 95%CI 0. 2-0. 9, p=0. 03) and older women were less likely to report improvement in urinary symptoms (OR 0. 98 95%CI 0. 96-0. 99, p= 0. 003). Factors not associated with improvement in urinary symptoms on multiple regression were dry mouth, baseline fluid intake volume, change in fluid intake volume, and caffeine intake volume.

In women with overactive bladder receiving fesoterodine, dry mouth may prevent women from restricting fluid intake, but does not diminish treatment efficacy.

The Journal of urology. 2015 Dec 09 [Epub ahead of print]

Steven J Weissbart, Rusell Lewis, Ariana L Smith, Heidi H Harvie, Janis M Miller, Lily A Arya

Division of Urogynecology and Pelvic Reconstructive Surgery, Dept. of OBGYN, University of Pennsylvania, Philadelphia, PA. Electronic address: Steven. Weissbart@uphs. upenn. edu. , Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. , Division of Urology, Dept. of Surgery, University of Pennsylvania, Philadelphia, PA. , Division of Urogynecology and Pelvic Reconstructive Surgery, Dept. of OBGYN, University of Pennsylvania, Philadelphia, PA. , School of Nursing, Dept. of Health Behavior and Biological Sciences and School of Medicine, Dept. of OBGYN, University of Michigan, Ann Arbor, MI. , Division of Urogynecology and Pelvic Reconstructive Surgery, Dept. of OBGYN, University of Pennsylvania, Philadelphia, PA.

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