Can vitamin D ease overactive bladder, urinary incontinence symptoms in older men?

Supplementation with vitamin D does not lead to improvements in overactive bladder or urinary incontinence relative to placebo, a study has shown. However, specific use of vitamin D in men with lower 25-hydroxyvitamin D levels shows inconsistent results.

Researchers conducted an ancillary study of men aged ≥55 years in VITAL*. Participants were randomly assigned to receive vitamin D₃ (cholecalciferol), marine omega-3 fatty acids, or matching placebo.

Using structured urinary incontinence questions, researchers measured the prevalence of overactive bladder at year 5 and urinary incontinence at years 2 and 5, as well as the incidence and progression of urinary incontinence from years 2 to 5. They also performed prespecified subgroup analyses to assess men with low baseline serum 25-hydroxyvitamin D (<20 ng/mL).

A total of 11,486 men had available data at year 2 and 10,474 at year 5. Their mean age at year 2 was 68 years, with 23 percent belonging to racial/ethnic minorities.

Primary analyses revealed that vitamin D supplementation fell short of reducing the odds of overactive bladder at year 5 (odds ratio [OR], 0.97, 95 percent confidence interval [CI], 0.7‒1.08) or weekly urinary incontinence at year 2 (OR, 0.94, 95 percent CI, 0.83‒1.05) or year 5 (OR, 0.98, 95 percent CI, 0.88‒1.09).

Interactions of baseline serum 25-hydroxyvitamin D level with vitamin D supplementation were observed for overactive bladder (p=0.001 for interaction) and, secondarily, for any urinary incontinence at year 2 (p=0.05 for interaction).

Notably, men with baseline 25-hydroxyvitamin D <20 ng/mL who received vitamin D supplements, compared to placebo, were less likely to develop an overactive bladder (OR, 0.51, 95 percent CI, 0.35‒0.76) but were more susceptible to any urinary incontinence (OR, 1.24, 95 percent CI, 0.93‒1.64).

*VITamin D and OmegA-3 TriaL