The Truly Healthy Bladder 2: Understanding Normal As A Pathway To Prevention Of Lower Urinary Tract Symptoms In Women

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The Prevention of Lower Urinary tract Symptoms (PLUS) Consortium is investing in understanding bladder health and lower-urinary track symptom prevention. The Consortium’s proposed healthy bladder definition is: “A complete state of physical, mental, and social well-being related to bladder function and not merely the absence of lower urinary tract symptoms (LUTS). Healthy bladder function permits daily activities, adapts to short-term physical or environmental stressors, and allows optimal well-being.” We are only beginning to understand the risk and protective factors that can potentiate or destroy well-being across the spectrum—from having a healthy bladder to experiencing chronic LUTS. One overarching, powerful component is the act of drinking and the state of the bladder, or what we call the Beverages to Bladder (B2B) balance. Across the life course, B2B is a fact—what goes in must come out, usually through the bladder. Despite the obvious, little data exists to guide adolescent and adult women in the what, when, and why of choosing beverage type, volume, and timing of intake as it pertains to promoting their bladder health. Our broad goal is to know what beverage intake pattern(s) relate best to a truly healthy bladder. To reach this goal, we aim to: 1) Determine the distribution of bladder health across the spectrum from healthy bladder to chronic LUTS in U.S. adolescent and adult women, monitoring changes in bladder health over time across the life course; 2) Establish and validate the optimal B2B balance across the life course by identifying beverage intake patterns and determining which are associated with the range of the bladder health spectrum; and 3) Explore adolescent and adult women’s lived experiences of B2B balance, including the biological, interpersonal, sociocultural, and environmental influences—any of which might be early facilitators or barriers to optimizing B2B balance over the life course. We will work closely within the PLUS consortium to launch a large population based observational survey study to measure bladder health, including knowledge, attitudes, and beliefs; as well as risk and protective factors. We will also have available a new data collection tool for use in this longitudinal study called Where I Go, a phone application developed at The University of Michigan. It captures beverage intake in real time, toileting experiences, and other influences affecting how adolescent and adult women manage B2B in their day-to-day lives. This data will be analyzed along with survey information and data in other pre-existing datasets. Each component offers uniqueness that can help us identify women’s variations in beverage intake patterns, and how patterns relate to bladder health across the life course. We hypothesize there is a best pattern for optimizing bladder health, but there may be many reasons why a woman’s beverage intake differs from a best pattern. We will use adolescents and adult women focus groups combined with Where I Go to learn what influences beverage intake. Ultimately, we hope to gain new insights to inform interventions to help each woman understand her B2B balance and optimize it for bladder health.