Objective: To determine whether there is an association in women between ca
ffeine intake and risk for detrusor instability.
Methods: Women were included if they had symptoms of urinary incontinence,
completed a 48-hour voiding diary detailing fluid and caffeine intake, and
had undergone standardized multichannel urodynamics. The study group had 13
1 women with detrusor instability on provocative cystometry and maximum ure
thral closure pressure greater than 20 cm of water. The control group had 1
28 women without detrusor instability on provocative cystometry and maximum
urethral closure pressure greater than 20 cm of water. For statistical com
parison, women were divided into the following three groups on the basis of
caffeine intake: minimal (< 100 mg/day), moderate (100-400 mg/day), and hi
gh (> 400 mg/day).
Results: The mean caffeine intake of women with detrusor instability (484 /- 123 mg/day) was significantly higher than that of controls (194 +/- 84 m
g/day, P =.002). On univariate analysis, significant risk factors for detru
sor instability were age, smoking status, and caffeine intake. On multivari
ate analysis, the statistically significant association between high caffei
ne intake and detrusor instability persisted after controlling for age and
smoking (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.1, 6.5, P =.01
8). When women with moderate caffeine intake were compared with those with
minimal caffeine intake, the risk for detrusor instability was lower and di
d not reach significant levels (OR 1.5, 95% CI 0.1, 7.2, P=.093).
Conclusion: An association between high caffeine intake and detrusor instab
ility was seen in this population. Larger studies are required to determine
whether the association is causal. (Obstet Gynecol 2000;96:85-9. (C) 2000
by The American College of Obstetricians and Gynecologists.).