—Researchers from Weill Cornell Medical College, New York, evaluated the efficacy of dried cranberry powder in alleviating OAB symptoms in women with OAB, without incontinence.

By Krithika Subramanian, PhD

Daily intake of dried cranberry powder improved some symptoms of overactive bladder (OAB) and the patients’ perception of their bladder condition in adult women, according to a recent study published in the September issue of the Journal of Urology.1

Take Note

• Overactive bladder is highly prevalent, affecting up to 12% of adults, with a significant impact on the quality of life and physical and psychological health of affected individuals.
• In a study published in the Journal of Urology, researchers found that daily intake of 500 mg of dried cranberry powder improved OAB symptoms and patient-reported bladder condition after the 24-week study period, compared with placebo.

The results from this single-center, randomized, double-blind, placebo-controlled study, conducted by researchers at the Weill Cornell Medical College, New York, showed that daily intake of 500 g of dried cranberry powder decreased daily micturition by 16.4% and urgency episodes by 57.3%, while also improving patient perception of bladder condition by 39.7%.1

The International Continence Society defines OAB as a syndrome that includes urinary urgency, usually accompanied by increased daytime frequency and/or nocturia, with urinary incontinence (OAB-wet) or without (OAB-dry), in the absence of urinary tract infection (UTI) or other detectable disease or pathology.2 OAB is highly prevalent, estimated to affect up to 12% of adults, with a projected cost of $82.6 billion this year in the United States.3,4 Although the joint guidelines for management of OAB published by the American Urological Association/Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction note that OAB is not a disease, OAB can have significant and broad impacts on the patient’s quality of life (QoL) and activities of daily living, productivity, physical and psychological health, sleep, and sexual function.5 OAB syndrome can also increase risk of incontinence-associated dermatitis and UTI.5

Range of OAB treatments

First-line treatment for OAB includes behavioral interventions such as bladder training, management of total daily fluid and caffeine intake and diet, avoidance of bladder irritants, weight loss, and pelvic floor physical therapy.3,5 While these interventions carry minimal risk and offer the possibility of QoL improvement, they are limited by the dependence on patients’ willingness to modify behavior and maintain changes and on the prolonged time commitment needed with a qualified therapist/clinician.5

Pharmacotherapy with 2 main classes of agents – oral antimuscarinics or oral β3-adrenoreceptor agonists – is the mainstay of second-line treatment; oral antimuscarinics include darifenacin, solifenacin, tolterodine, fesoterodine, and trospium, while mirabegron and the investigational agents vibegron and solabegron are oral β3-adrenoreceptor agonists of interest for OAB.3,5

The choice of oral agent depends on the side effect profile, patient tolerance, and contraindications.3 The side effects of the 2 classes of agents – dry mouth, dry eyes, gastrointestinal disturbances, urinary retention, and impaired cognitive function in the case or antimuscarinics and increased blood pressure, nasopharyngitis, UTIs, and urinary retention in the case of β3 adrenergic agonists – are the major limitations to their use.3,5 Third-line therapies, such as sacral neuromodulation and intradetrusor injection of onabotulinumtoxinA (“botox”) are advanced therapies for carefully selected patients and are associated with unique risk-benefit profiles.3,5 Based on the efficacy of the significant improvement in lower urinary tract symptoms with 6-month daily intake of dried cranberry powder in men in a randomized clinical trials, the authors sought to evaluate the efficacy of daily consumption of dried cranberry on women with dry-OAB in the current study.

Dried cranberry powder improves symptoms in women with dry OAB

A total of 98 women, 18 years or older, with dry OAB (mean duration of OAB symptoms, 1.9 ± 2.67 years), were randomized in this study to receive either dried cranberry powder pill containing 500 mg of proprietary full spectrum dried cranberry fruit (V. macrocarpon, Aiton) or a placebo pill with a mixture of maltodextrin and food grade colors. Data for 60 participants, only those who completed all study visits and complied with the study protocol, was included in the per-protocol population data set. The primary outcome of treatment success, defined as an average of 1 or more void reduction per day, the number and degree of urinary incontinence episodes, urge severity, presence of nocturia and fluid intake, was assessed using a 3-day voiding diary. Secondary measure of treatment success was defined as ≥5-point decrease in the Overactive Bladder Questionnaire Short Form (OABQ-SF) score from baseline compared with 24 weeks. Patient-reported outcomes were also assessed using the Patient Perception of Bladder Condition (PPBC) and Sexual Quality of Life-Female and Pelvic Floor Disability Index 20.