(Poster 119) Methamphetamine Exposure on Lower Urinary Tract Symptoms in Women

Objectives: Substances like tobacco, marijuana, alcohol, and ketamine negatively impact urinary tract function, but the effects of methamphetamine on lower urinary tract symptoms in women remain unclear. This study aims to assess whether methamphetamine exposure increases the risk of lower urinary tract dysfunction in women.

Methods: A retrospective analysis was conducted using de-identified patient data from the TriNetX United States collaborative network, comprising 25 million patients across 68 healthcare organizations. Women aged 18 to 51 with documented methamphetamine exposure were identified. Exclusion criteria included history of bladder malignancy, congenital bladder malformations, urogenital or gastrointestinal malignancies, prior radiation, neurologic disorders (e.g., multiple sclerosis, spina bifida, neurogenic bladder), hysterectomy, current pregnancy, or prior history of outcomes of interest. Propensity score matching ensured comparability between methamphetamine-exposed and non-exposed groups based on demographics, comorbidities (hypertension, hyperlipidemia, chronic kidney disease, Type 2 diabetes, heart failure), other substance dependencies (nicotine, alcohol, cannabis, opioid, cocaine), and vaginal delivery history. Primary outcomes included incontinence (urgency, stress, mixed), urinary urgency, frequency, dysuria, nocturia, retention, and urinary tract infections (UTIs). Outcomes were assessed from 30 days up to 10 years following methamphetamine exposure. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated, with significance set at p< 0.05. Kaplan-Meier survival analysis compared hazard ratios (HRs) between groups.

Results: After matching, 19,751 patients were identified in each cohort. Methamphetamine exposure was associated with a significantly increased risk of UTIs (OR: 1.22, 95% CI [1.14–1.32]). The Kaplan-Meier curve demonstrated a significantly shorter time to first urinary tract infection in the methamphetamine-exposed cohort compared to the unexposed group (log-rank p< 0.01). Conversely, no methamphetamine exposure led to higher risks of stress incontinence (OR: 0.71, 95% CI [0.59–0.84]), dysuria (OR: 0.92, 95% CI [0.85–0.99]), urinary urgency (OR: 0.80, 95% CI [0.70–0.91]), urinary frequency (OR: 0.84, 95% CI [0.77–0.91]), and nocturia (OR: 0.64, 95% CI [0.47–0.86]). No significant differences were observed for urge incontinence, mixed incontinence, or urinary retention between groups.

Conclusions: These findings suggest that methamphetamine exposure is associated with an increased risk and earlier onset of UTIs. Individuals without methamphetamine exposure had a higher risk of multiple lower urinary tract symptoms—including stress incontinence, dysuria, urinary urgency, urinary frequency, and nocturia—compared to those with methamphetamine exposure. Early interventions among clinicians, such as prophylactic antibiotics, may improve patient outcomes and allow for more personalized care. These results underscore the complex relationship between methamphetamine use and urinary health in women and highlight the need for further research to explore underlying mechanisms and clinical implications. Figure 1. Risk of outcomes for nocturia, urinary frequency, urinary urgency, UTIs, dysuria, and stress incontinence between methamphetamine-exposed and non-exposed groups. Table 1. Measures of association for urinary tract infections between cohorts. Figure 2. Kaplan-Meier curve comparing time to first urinary tract infection between cohorts.