Top

International Urogynecology Journal

Published in:

01-07-2018 | Original Article

Effects of urine alkalinization with sodium bicarbonate orally on lower urinary tract symptoms in female patients: a pilot study

Authors: Mehmet Giray Sönmez, Yunus Emre Göğer, Gökhan Ecer, Ahmet Atıcı, Mehmet Serkan Özkent, Ahmet Öztürk

Published in: International Urogynecology Journal | Issue 7/2018

Abstract

Introduction and hypothesis

In this study, we planned to explore the effects of sodium bicarbonate orally (NaHCO3) treatment on female patients with lower urinary tract symptoms (LUTS) who have acidic urine pH values (<6).

Methods

NaHCO3 was given orally to 33 female patients for 4 weeks at a dose of 2 × 4 g/day. Laboratory values, bladder diary, the Patient Perception of Bladder Condition Score (PPBC), Patient Perception of Intensity of Urgency Scale (PPIUS), Overactive Bladder–Validated 8-question Awareness tool (OAB-V8), Pelvic Pain and Urgency & Frequency Patient Symptom Scale tests (PUFSS), and the King’s Health Questionnaire (KHQ) scores before and after treatment were compared.

Results

A significant increase was detected in urine pH values measured after treatment (5.31 ± 0.52 to 7.2 ± 0.66, p < 0.001), but not in blood pH values (7.369 ± 0.33 to 7.384 ± 0.28, p = 0.14). After treatment, a significant decrease was detected in daily frequency, nocturia, urgency, and urge incontinence prevalence (p < 0.001,p = 0.003, p < 0.001, p = 0.002, respectively) and PPBC, PPIUS, PUFSS, and OAB-V8 symptom scores (p = 0.004, p = 0.002, p < 0.001, p < 0.001, respectively). A significant decrease was detected in all KHQ subunit scores.

Conclusion

Urine alkalinization with NaHCO3 orally in female patients with LUTS and acidic urine pH has a significant level of positive effects on symptoms and symptom scores. Our results show that this new treatment modality—which is inexpensive, easy to use, and has a low side-effect profile is effective in this chronic patient group.

Varella LR, Bezerra da Silva R, Eugênia de Oliveira MC, Melo pH, Maranhão TM, Micussi MT. Assessment of lower urinary tract symptoms in different stages of menopause. J Phys Ther Sci. 2016;28(11):3116–21.CrossRefPubMedPubMedCentral

Denys MA, Anding R, Tubaro A, Abrams P, Everaert K. Lower urinary tract symptoms and metabolic disorders: ICI-RS 2014. Neurourol Urodyn. 2016;35(2):278–82.CrossRefPubMed

Coyne KS, Sexton CC, Bell JA, Thompson CL, Dmochowski R, Bavendam T, et al. The prevalence of lower urinary tract symptoms (LUTS) and overactive bladder (OAB) by racial/ethnic group and age: results from OAB-POLL. Neurourol Urodyn. 2013;32(3):230–7.CrossRefPubMed

Bilge C, Beji NK. Life quality scales used for evaluating Urinar symptoms in women. J Female Funct Urol. 2015;1-4:41–5.

Sanford MT, Rodriguez LV. The role of environmental stress on lower urinary tract symptoms. Curr Opin Urol. 2017;27(3):268–73.CrossRefPubMed

Zhang HL, Huang ZG, Qiu Y, Cheng X, Zou XQ, Liu TT. Tamsulosin for treatment of lower urinary tract symptoms in women:a systematic review and meta-analysis. Int J Impot Res. 2017;29(4):148–56.CrossRefPubMed

Cox L, Rovner ES. Lower urinary tract symptoms in women: epidemiology, diagnosis, and management. Curr Opin Urol. 2016;26(4):328–33.CrossRefPubMed

Canda AE, Cross CR, Chapple CR. Pharmacology of the lower urinary tract and Management of Overactive Bladder. J Turkish-German Gynecol Assoc. 2006;7:146–57.

Gormley EA, Lightner DJ, Faraday M, Vasavada SP. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. American urological association; Society of Urodynamics, female pelvic medicine. J Urol. 2015;193(5):1572–80.CrossRefPubMed

10.

Yi JH, Shin HJ, Kim SM, Han SW, Kim HJ, Oh MS. Does the exposure of urine samples to air affect diagnostic tests for urine acidification? Clin J Am Soc Nephrol. 2012;7(8):1211–6.CrossRefPubMedPubMedCentral

11.

Demirbas A, Sarici H, Kilinc MF, Telli O, Ozgur BC, Doluoglu OG, et al. The relationship between acidic urinary pH and overactive bladder; alkalization of urine improves the symptoms of overactive bladder. Urol Int. 2015;95(2):223–6.CrossRefPubMed

12.

Fjellstedt E, Denneberg T, Jeppsson JO, Tiselius HG. A comparison of the effects of potassium citrate and sodium bicarbonate in the alkalinization of urine in homozygous cystinuria. Urol Res. 2001;29:295–302.CrossRefPubMed

13.

Kobayashi H, Yoshiyama M, Zakoji H, Takeda M, Araki I. Sex differences in the expression profile of acid-sensing ion channels in the mouse urinary bladder: a possible involvement in irritative bladder symptoms. BJU Int. 2009;104:1746–51.CrossRefPubMed

14.

Wong GY, Gavva NR. Therapeutic potential of vanilloid receptor TRPV1 agonists and antagonists as analgesics: recent advances and setbacks. Brain Res Rev. 2009;60(1):267–77.CrossRefPubMed

15.

Sánchez-Freire V, Blanchard MG, Burkhard FC, Kessler TM, Kellenberger S, Monastyrskaya K. Acid-sensing channels in human bladder: expression, function and alterations during bladder pain syndrome. J Urol. 2011;186(4):1509–16.CrossRefPubMed

16.

Munday PE. Cymalon in the management of urinary tract symptoms. Genitourin Med. 1990;66(6):460–2.

17.

Brumfitt W, Hamilton-Miller JM, Cooper J, Raeburn A. Relationship of urinary pH to symptoms of 'cystitis'. Postgrad Med J. 1990;66(779):727–9.CrossRefPubMedPubMedCentral

18.

Hohlbrugger G, Lentsch P. Intravesical ions, osmolality and pH influence the volume pressure response in the normal rat bladder, and this is more pronounced after DMSO exposure. Eur Urol. 1985;11(2):127–30.CrossRefPubMed

19.

Friedlander JI, Shorter B, Moldwin RM. Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions. BJU Int. 2012;109(11):1584–91.CrossRefPubMed

20.

Proudfoot AT, Krenzelok EP, Vale JA. Position paper on urine alkalinization. J Toxicol Clin Toxicol. 2004;42(1):1–26.CrossRefPubMed

21.

Cohen B, Laish I, Brosh-Nissimov T, Hoffman A, Katz LH, Braunstein R, et al. Efficacy of urine alkalinization by oral administration of sodium bicarbonate: a prospective open-label trial. Am J Emerg Med. 2013;31(12):1703–6.CrossRefPubMed

22.

Takahashi S, Takei M, Nishizawa O, Yamaguchi O, Kato K, Gotoh M, et al. Clin Guid Female Lower Urinary Tract Symp. 2016;8(1):5–29.CrossRef

23.

Wagg A, Compion G, Fahey A, Siddiqui E. Persistence with prescribed antimuscarinic therapy for overactive bladder: a UK experience. BJU Int. 2012 Dec;110(11):1767–74.CrossRefPubMed

24.

Basra RK, Wagg A, Chapple C, Cardozo L, Castro-Diaz D, Pons ME, et al. A review of adherence to drug therapy in patients with overactive bladder. BJU Int. 2008;102(7):774–9.CrossRefPubMed

25.

Yoshimura N. Underlying mechanisms of interstitial cystitis/painful bladder syndrome (IC/PBS). Nishinihon J Urol. 2009;71(6):243–52.

26.

Ueda T, Yoshida T, Tanoue H, Ito M, Tamaki M, Ito Y, et al. Urine alkalization improves the problems of pain and sleep in hypersensitive bladder syndrome. Int J Urol. 2014;21(5):512–7.CrossRefPubMed

27.

Tolouian R, Wild D, Lashkari MH, Najafi I. Oral alkalinizing solution as a potential prophylaxis against myoglobinuric acute renal failure: preliminary data from healthy volunteers. Nephrol Dial Transplant. 2005;20(6):1228–31.CrossRefPubMed

Title: Effects of urine alkalinization with sodium bicarbonate orally on lower urinary tract symptoms in female patients: a pilot study
Authors: Mehmet Giray Sönmez
Yunus Emre Göğer
Gökhan Ecer
Ahmet Atıcı
Mehmet Serkan Özkent
Ahmet Öztürk
Publication date: 01-07-2018
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 7/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-017-3492-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effects of urine alkalinization with sodium bicarbonate orally on lower urinary tract symptoms in female patients: a pilot study

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2018

Patients’ perception and satisfaction with pulsed magnetic stimulation for treatment of female stress urinary incontinence

Re: The article “Detrusor pressures in urodynamic studies during voiding in women”

Recalcitrant chronic bladder pain and recurrent cystitis but negative urinalysis: What should we do?

Laparoscopic implantation of electrodes for bilateral neuromodulation of the pudendal nerves and S3 nerve roots for treating pelvic pain and voiding dysfunction

Quality of randomized controlled trials published in the International Urogynecology Journal 2007–2016

Commentary on: Comparison of inflammatory urine markers in patients with interstitial cystitis and overactive bladder