Background: To determine association between urine pH and OAB symptoms and to determine if urinary alkalization improves overactive bladder (OAB) symptoms. Methods: 659 patients with OAB were enrolled in this study between June 2012 and May 2014. 329 patients (group 1) were included in the final analysis. 201 adults were used as a control group (group 2). 24-hour urinary pH and the validated Turkish version of the OAB-V8 questionnaire were performed in patients. A 24-hour urine pH <6.2 was considered acidic urine. In the second part, a diet program was performed for 4 weeks in 30 participants. Urine pH values and OAB-V8 scoring results were recorded before the diet program and 2 and 4 weeks after the diet program. Results: Acidic urinary pH was determined in 61.4% of patients with OAB. There was a significant association between the presence of acidic urine and OAB. Also, the OAB-V8 scores of patients were significantly higher in patients with acidic urine than nonacidic urine. OAB-V8 scores of patients showed statistically significant improvement after diet therapy (17.87 ± 6.52 vs. 10.43 ± 7.17; p < 0.001). Conclusions: We found that acidic urinary pH was closely associated with OAB, and alkalization of urine improved lower urinary tract symptoms. We suggest that urinary pH should be considered as a parameter in treatment planning of patients with OAB.

1.
Abrams P, Cardozo L, Fall M, et al: The standardization of terminology in lower urinary tract function: report from the standardization sub-committee of the International Continence Society. Urology 2003;61:37-49.
2.
Haylen BT, de Ridder D, Freeman RM, et al; International Urogynecological Association; International Continence Society: An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfuntion. Neurourol Urodyn 2010;29:4-20.
3.
Stewart WF, Van Rooyen JB, Cundiff GW, et al: Prevalence and burden of overactive bladder in the United States. World J Urol 2003;20:327-336.
4.
Irwin DE, Milsom I, Hunskaar S, et al: Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 2006;50:1306-1314; discussion 1314-1315.
5.
Michel MC, Chapple CR: Basic mechanisms of urgency: preclinical and clinical evidence. Eur Urol 2009;56:298-307.
6.
Brumfitt W, Hamilton-Miller JMT, Cooper J, Raeburn A: Relationship of urinary pH to symptoms of ‘cystitis'. Postgrad Med J 1990;66:727-729.
7.
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;11:127-130.
8.
Munday PE: Cymalon in the management of urinary tract symptoms. Genitourin Med 1990;66:460-462.
9.
Tarcan T, Mangir N, Ozgur MO, Akbal C: OAB-V8 Overactive Bladder Questionnaire Validation Study. Üroloji Bülteni 2012;21:113-116.
10.
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.
11.
Janig W, Morrison J: Functional properties of spinal visceral afferents supplying abdominal and pelvic organs, with special emphasis on visceral nociception. Prog Brain Res 1986;67:87-114.
12.
Habler HJ, Janig W, Koltzenburg M: Activation of unmyelinated afferent fibers by mechanical stimuli and inflammation of the urinary bladder in the cat. J Physiol 1990;425:545-562.
13.
Yoshimura N: Underlying mechanisms of interstitial cystitis/painful bladder syndrome (IC/PBS). Nishinihon J Urol 2009;71:243-252.
14.
Wong GY, Gavva NR: Therapeutic potential of vanilloid receptor TRPV1 agonists and antagonists as analgesics: recent advances and setbacks. Brain Res Rev 2009;60:267-277.
15.
Kobayashi H, Yoshiyama M, Zakoji H, 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;104:1746-1751.
16.
Maalouf NM, Cameron MA, Moe OW, Skhaee K: Metabolic basis for low urine pH in type 2 diabetes. Clin J Am Soc Nephrol 2010;5:1277-1281.
17.
Hara S, Tsuji H, Ohmoto Y, et al: High serum uric acid level and low urine pH as predictors of metabolic syndrome: a retrospective cohort study in a Japanese urban population. Metabolism 2012;61:281-288.
18.
Tai HC, Chung SD, Ho CH, et al: Metabolic syndrome components worsen lower urinary tract symptoms in women with type 2 diabetes. J Clin Endocrinol Metab 2010;95:1143-1150.
19.
Gorbachinsky I, Akpinar H, Assimos DG: Metabolic syndrome and urological disease. Rev Urol 2010;12:e157-e180.
20.
Lee SR, Kim HJ, Kim A, Kim JH: Overactive bladder is not only overactive but also hypersensitive. Urology 2010;75:1053-1059.
21.
van Brummen HJ, Heintz AP, van der Vaart CH: The association between overactive bladder symptoms and objective parameters from bladder diary and filling cystometry. Neurourol Urodyn 2004;23:38-42.
22.
Ueda T, Yoshida T, Tanoue H, Ito M, Tamaki M, Ito Y, Yoshimura N: Urine alkalization improves the problems of pain and sleep in hypersensitive bladder syndrome. Int J Urol 2014;21:512-517.
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