The Functional Effects of Cigarette Smoking in Women on the Lower Urinary Tract

Abstract

The aim of the study was to evaluate the urodynamic findings in women who smoke cigarettes, with bothersome lower urinary tract symptoms, to help develop an understanding of potential impact of smoking on the lower urinary tract function. Methods: A database of 11,678 women who underwent urodynamic testing in a tertiary referral centre in the United Kingdom, from January 1991 to December 2009 was retrospectively analysed. All women reporting cigarette smoking were included in the study group. Urodynamic testing and interpretation of results were done in accordance with the recommendations of the International Continence Society. Results: Overall, 2,476 (21.2%) women reported smoking cigarettes. Overactive bladder symptoms (OAB) were more common in smokers (OR 1.14, p = 0.006). Female smokers significantly complained of secondary nocturnal enuresis (OR 2.26, p < 0.001) and coital incontinence (CI; OR 1.14, p < 0.001). Detrusor overactivity (DO; OR 1.42, p < 0.001) and detrusor overactivity incontinence (DOI; OR 1.42, p < 0.001) were the most significant urodynamic findings. Smoking was not shown to be significantly associated with SUI (OR 1.08, p = 0.213) or urodynamic stress incontinence (OR 0.86, p = 0.001). Conclusion: Cigarette smoking is associated with OAB, secondary nocturnal enuresis and CI. DO and DOI are the most significant urodynamic findings.