Healthy Habits May Improve Urinary, Sexual Function

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SAN FRANCISCO—Healthy lifestyle choices, such as not smoking and exercising regularly, may significantly impact urinary and sexual function, two studies suggest.

Using the FINNO (Finnish National Nocturia and Overactive Bladder) Study cohort, researchers surveyed a population-based sample of more than 2,000 Finnish women aged 18 to 79 about their smoking habits and urinary function. After controlling for socioeconomics, lifestyle, reproductive factors, comorbidities, and medication use, the researchers found that current and former smokers had a 2.7 and 1.8 increased likelihood of urinary urgency, respectively, and a 3.0 and 1.7 times increased likelihood of increased daytime frequency compared with women who never smoked. The study revealed no association between current or former smoking and nocturia or stress urinary incontinence.

For this study, researchers mailed questionnaires to about 3,000 women randomly selected from the national population registry. A total of 2,002 (response proportion 67%) women agreed to participate, and 114 were excluded due to pregnancy, puerperium, or urinary tract infection. Increased daytime frequency, nocturia, stress urinary incontinence, urgency, and urgency urinary incontinence was reported by 7.1%, 12.6%, 11.2%, 9.7%, and 3.15 of women, respectively.

“We really think that smoking has a direct impact,” said lead investigator Kari Tikkinen, MD, PhD, a urology resident and epidemiologist at Helsinki University Central Hospital, Helsinki, Finland. “We didn't look at molecular models but nicotine may be involved. Nicotine affects the bladder and the brain and there are many other toxic compounds in tobacco that can cause ischemia and affect urinary function - nitric oxide levels may also be involved.”

According to Dr. Tikkinen, urologists can now tell their patients that being a current smoker “almost triples your risk of having urinary urgency and increased daytime frequency.”

In a separate study of the relationship between exercise and sexual function, researchers from North Carolina studied 178 healthy men at the Durham VA Medical Center using the UCLA PCI Survey, which includes six questions on sexual function. A separate survey related to current exercise habits also was administered. Sexual function was calculated by converting the answers to a numeric score and exercise was calculated by converting the responses to metabolic equivalent tasks (MET) hours per week.

The men had a median age of 62 years and their median BMI was 31 kg/m2.  Fifty-nine men (33%) were African American and 111 (62%) were Caucasian. The median sexual function score was 53 points. After adjusting for age, race, BMI, heart disease, diabetes, medications, and depression, men who exercised the most on a weekly basis had significantly higher sexual function scores.

“We found that men who exercise nine MET hours a week or more were 65% less likely to have sexual dysfunction in our group,” said lead investigator Erin McNamara, MD, a urology resident in the division of urologic surgery at Duke University in Durham, N.C.

Nine MET hours is equivalent to about 30 minutes of brisk walking four days a week, Dr. McNamara explained.

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