Development Of Overactive Bladder Research Articles

The role of prostaglandin and E series prostaglandin receptor type 4 receptors in the development of bladder overactivity in a rat model of chemically induced prostatic inflammation.

To evaluate, using a rat model of non-bacterial prostatic inflammation, the prostaglandin production and expression profiles of E-series prostaglandin (EP) receptor subtypes, which are reportedly implicated in the development of overactive bladder, in the bladder mucosa, and to investigate the effect of EP receptor type 4 (EP4) blockade on bladder overactivity after prostatic inflammation. Male Sprague-Dawley rats were used. Prostatic inflammation was induced by formalin injection (5%; 50μL per lobe) into the bilateral ventral lobes of the prostate. At 10days after induction of prostatic inflammation or vehicle injection, bladder tissues from the deeply anaesthetized rats were harvested and separated into mucosal and detrusor layers. Then, prostaglandin E2 (PGE2) concentrations and protein levels of PGE2 receptors (EP1-4) in the bladder mucosa and detrusor were measured by ELISA and Western blotting, respectively. In separate groups of control and formalin-treated rats, awake cystometry was performed to evaluate the changes in bladder activity after prostatic inflammation. In addition, the effect of intravesical administration of a selective EP4 antagonist (ONO-AE3-208; 30μm) on bladder activity was evaluated in control rats and rats with prostatic inflammation. PGE2 concentration and protein levels of EP4, but not other EP receptor subtypes, in the bladder mucosa and detrusor layers were significantly increased in formalin-injected rats vs vehicle-injected control rats. In cystometry, rats with prostatic inflammation exhibited a significant decrease in intercontraction intervals (ICIs) compared with control rats. Intravesical application of ONO-AE3-208 (30μm), but not vehicle application, significantly increased ICIs in rats with prostatic inflammation, whereas ONO-AE3-208 at this concentration did not significantly affect any cystometric values in control rats. Because intravesical administration of an EP4 antagonist effectively improved bladder overactivity after prostatic inflammation, EP4 activation, along with increased PGE2 production in the bladder mucosa, seems to be an important contributing factor to bladder overactivity induced by prostatic inflammation. Thus, blockade of EP4 in the bladder could be a therapeutic approach to male lower urinary tract symptoms attributable to benign prostatic hyperplasia with prostatic inflammation.

Is nocturnal enuresis a predisposing factor for the overactive bladder?

Background/aimThis study aimed to perform a limited observational study to ascertain whether there is statistical support that nocturnal enuresis (NE) is a predisposing factor in the development of overactive bladder (OAB).Materials and methods The authors recruited patients diagnosed with OAB over a period of twelve months, and those who declared a history of NE were asked additional questions regarding the features of their NE.ResultsA total of 285 patients were diagnosed with overactive bladder, and 98 (34.38%) of them had previously displayed NE symptoms that had diminished before reaching the median age of 9.83. Separation of patients by sex revealed a male majority (58.16%). Additionally, most patients had urban origins (75.51%). The median time span from remission of NE to diagnosis of OAB was 24.79 years, and the median age at which patients began to suffer was 31.80 years. Behavioral factors (smoking, alcohol consumption) and psychological and infectious factors (past history of urinary tract infection) were identified at varying degrees.Conclusion The presence of NE in a third of the patients who developed over time OAB and the earlier onset of OAB for these patients suggests a causal physiopathological relationship between NE and OAB. The preponderance of urban patients confirms the existence of acquired urban triggering factors of OAB (nutritious, social, or professional).

MP26-09 INVOLVEMENT OF TOLL-LIKE RECEPTOR 4 IN NONBACTERIAL BLADDER INFLAMMATION AND FREQUENT URINATION VIA INFLAMMASOME PATHWAYS IN SPONTANEOUSLY HYPERTENSIVE RATS

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Basic Research & Pathophysiology I1 Apr 2017MP26-09 INVOLVEMENT OF TOLL-LIKE RECEPTOR 4 IN NONBACTERIAL BLADDER INFLAMMATION AND FREQUENT URINATION VIA INFLAMMASOME PATHWAYS IN SPONTANEOUSLY HYPERTENSIVE RATS Shinsuke Mizoguchi, Kenichi Mori, Naoyuki Yamanaka, Fuminori Sato, Naoki Yoshimura, and Hiromitsu Mimata Shinsuke MizoguchiShinsuke Mizoguchi More articles by this author , Kenichi MoriKenichi Mori More articles by this author , Naoyuki YamanakaNaoyuki Yamanaka More articles by this author , Fuminori SatoFuminori Sato More articles by this author , Naoki YoshimuraNaoki Yoshimura More articles by this author , and Hiromitsu MimataHiromitsu Mimata More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.780AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although several studies have suggested that chronic bladder inflammation associated with oxidative stress contribute to overactive bladder (OAB), the underlying pathophysiological mechanism is unclear. Recently, the toll-like receptor (TLR) 4 has been reported to play a role in triggering chronic inflammatory conditions through activation of NLRP3 inflammasome pathways followed by production of IL1β and IL18. Although oxidative stress is one of factors that activate TLR4, it is not known whether changes in the expression of TLR4 are involved in the development of OAB caused by chronic inflammation. We therefore investigated an alteration of histopathology and expression of TLR4 and NLRP3 inflammasome-related molecules in the bladder using spontaneously hypertensive rats (SHRs) as an OAB model. METHODS Twenty-weeks-old male SHRs and Wistar Kyoto rats (control) were used. After voiding function was analyzed by using metabolic cages, the bladder was excised for analysis of histopathology and mRNA expression. Hematoxylin eosin and Masson′s trichrome stain were performed to analyze bladder inflammatory condition and fibrosis. Immunohistostaining for NLRP3, TLR4 was also performed. Expression levels of NLRP3, IL1β, IL-18, IL6, IL8 and TGFβ mRNA in the bladder were investigated by real-time PCR. Statistical analysis was performed using Mann-Whitney U test. P value less than 0.05 was considered statistically significant. RESULTS In voiding function analyses, single urine volume was significantly decreased and voiding frequency was significantly increased in SHRs compared to control rats. In histological evaluation, suburothelial fibrosis was shown in SHRs compared to controls. Furthermore, immunohistostaining showed localized expression of NLRP3 and TLR4 in the bladder urothelium in both groups. In RT-qPCR analyses, mRNA expression levels of NLRP3, TLR4, IL1β, IL-18, IL6, IL8 and TGFβ were significantly increased in SHRs in the bladder compared to controls. CONCLUSIONS These results suggest that activation of TLR4 associated with oxidative stress is implicated in bladder chronic inflammation, which leads to frequent urination through NLRP3 inflammasome pathways. Therefore, further clarification of interactions between TLR4 and inflammasome pathways may offer new therapeutic targets for OAB associated with chronic inflammation. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e322-e323 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Shinsuke Mizoguchi More articles by this author Kenichi Mori More articles by this author Naoyuki Yamanaka More articles by this author Fuminori Sato More articles by this author Naoki Yoshimura More articles by this author Hiromitsu Mimata More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Expression of brain derived-neurotrophic factor and granulocyte-colony stimulating factor in the urothelium: relation with voiding function.

BackgroundWe designed this experiment to elucidate the relationship between the expression of brain derived-neurotrophic factor (BDNF), the expression of granulocyte-colony stimulating factor (G-CSF), and the development of overactive bladder (OAB). In our previous study, the urothelium was observed to be more than a simple mechanosensory receptor and was found to be a potential therapeutic target for OAB. Moreover, neuregulin-1 and BDNF were found to be potential new biomarkers of OAB. Here, we investigated the relationship between changes in the voiding pattern and the expression of BDNF and G-CSF in the urothelium and evaluated the effects of 5-hydroxymethyl tolterodine (5-HMT) on rats with bladder outlet obstruction (BOO).MethodsA total of 100 Sprague–Dawley rats were divided into the following groups: 20 control rats; 40 BOO rats; and 40 BOO rats administered 5-HMT (0.1 mg/kg). After BOO was induced for 4 weeks, the rats were assessed by cystometrography. The changes in BDNF and G-CSF expression were examined in both separated urothelial tissues and in cultured urothelial cells by reverse transcription polymerase chain reaction (RT-PCR).ResultsBOO rats showed increased non-voiding activity [NVA; (number/10 voidings)] and bladder weight and decreased micturition volume (MV), micturition interval (MI), and micturition time (MT) relative to the controls. Moreover, the 5-HMT administration rats showed decreased NVA and bladder weight and increased MV and MI in comparison to the BOO rats. BDNF and G-CSF expression was increased in BOO rats and decreased following 5-HMT administration. In this model, voiding dysfunction developed as a result of BOO. As a therapeutic agent for OAB, the administration of 5-HMT improved the voiding dysfunction.ConclusionsBDNF and G-CSF might modulate voiding patterns through micturition pathways and might be involved only in the urothelium. Moreover, the expression of both genes in the urothelium might be related to voiding dysfunction in OAB patients. Thus, the urothelium has an important role in the manifestation of voiding symptoms.

1606 FUNCTIONAL PLASTICITY OF AUTONOMIC PELVIC GANGLIA IN RAT MODELS OF OVERACTIVE BLADDER

INTRODUCTION AND OBJECTIVES: Bladder outlet obstruction (BOO) in benign prostatic hyperplasia (BPH), a common problem affecting elderly men, caused urinary symptoms such as urgency, frequency, incomplete bladder emptying, and weak urine flow. Overactive bladder (OAB) is a syndrome characterized by urinary urgency with frequency and nocturia. Peripheral autonomic major pelvic ganglion (MPG) neurons are essential for the generation of storage and voiding reflexes. Under certain pathophysiological conditions such as spinal cord injury and chronic cystitis, plastic alterations in MPG neurons may cause abnormal functions of the bladder. But neurogenic mechanisms underlying OAB remain poorly understood. The hypothesis of the present study is that OAB is associated with changes in functions of MPG and dorsal roots ganglion (DRG) neurons in bladder outlet obstruction (BOO) rat models. METHODS: We were examined whether partial BOO alters expression and activity of nicotinic acetylcholine receptors (nAChRs) involved in synaptic transmission within MPG, and excitability of MPG and DRG neurons innervating the urinary bladder. Toward this end, rat models of partial urethral obstruction (PUO) and BPH were produced by partial urethra ligation and sc injection of testosterone/17-ƒo-estradiol, respectively. Cystometry were performed, indicating development of OAB. Real-time PCR analysis showed that the nAChRs ƒN3 and £4 subunits were up-regulated in MPG neurons of BOO rats. Then, nAChR currents were measured in DiI-labeled sympathetic and parasympathetic MPG neurons innervating the bladder detrusor muscles. RESULTS: nAChR current densities were significantly increased in parasympathetic MPG neurons, but not in sympathetic PG neurons. Under the current-clamp mode of the patch-clamp technique, action potentials were recorded in DRG and MPG neurons of control and BOO rats. BOO produced hyperexcitability of the bladder DRG and MPG neurons via reducing rheobase and AHP duration. One of the ionic mechanisms underlying the hyperexcitability is up-regulation of T-type Ca2 channels expressed in DRG and sympathetic MPG neurons. The decreased AHP duration also suggest that expression of Ca2 -activated Cland/or K (i.e., SK channels) might be altered in the bladder DRG and MPG neurons of BOO rats. CONCLUSIONS: BOO-induced OAB might be associated with enhanced ganglionic transmission and/or hyperexcitability of peripheral autonomic motor and sensory neurons innervating the bladder. Clinically, use of T-type Ca2 channel blockers might be a potential option of pharmacologic management of OAB.

122 THE ROLE OF SPLICING OF THE SLO GENE IN THE DEVELOPMENT OF DIABETIC CYSTOPATHY

INTRODUCTION AND OBJECTIVES: It is well documented that the MaxiK potassium channel (encoded by the slo gene) plays an important role in the maintenance of proper detrusor smooth muscle tone. However, studies have not addressed the role that post-transcriptional splicing of the slo gene plays in regulating MaxiK activity, and how the different resulting MaxiK isoforms may contribute to the development of bladder pathophysiology. In the present studies we correlated changes in slo splicing and MaxiK activity in both detrusor and urothelium tissue with the development of overactive bladder in an animal model of diabetes (the streptotozotocin (STZ)-diabetic animal). METHODS: Male rats were made diabetic for two months by injection of 35 mg/kg STZ and compared with age-matched, nondiabetic controls. Cystometry was performed on conscious free moving animals prior to the isolation of bladder, which was separated into detrusor and urothelium tissue by dissection. MaxiK expression was determined through patch clamping and Western blot analysis, and changes in slo splice variants through quantitative RT-PCR. RESULTS: In control, non-diabetic rats there is a regular periodic emptying of the bladder (mean 10/hour) at the same volume (mean 1.2ml) and pressure (mean 49cmH2O) with each micturition event. The micturition pressure was low and the bladder was quiescent between voiding episodes. In STZ-diabetic rats there was more variability in frequency of micturition (mean 4/hour), volume (mean 3ml) and pressures (mean 68cmH2O). Between micturitions multiple spontaneous low pressure bladder contractions were observed, none of which produced voiding. The changes in cystometry in the diabetic animals correlated with a significant, 43% decrease, in MaxiK channel activity. Overall there was a 50% decrease in transcription of the slo gene. The composition of the slo transcript pool was altered in the diabetic compared to non-dianetic animals, with less of a decrease in the expression of a dominant negative splice variant but a significantly greater decrease in the expression of a more calcium sensitive slo splice variant (called STREX). The expression of slo splice variants was also shown to be markedly different between the detrusor and urothelium. CONCLUSIONS: We have shown that diabetes causes changes in the slo splicing which would impact MaxiK expression and activity and could contribute to the development of diabetic cystopathy. Differences in the expression of the slo splice variant expressed in the urothelium and detrusor tissue suggests that MaxiK may have different physiological roles in these two tissues.

Suppression of bladder overactivity and oxidative stress by the phytotherapeutic agent, Eviprostat, in a rat model of atherosclerosis‐induced chronic bladder ischemia

To clarify the mechanism by which chronic bladder ischemia causes bladder functional changes, and to investigate the involvement of oxidative stress and pro-inflammatory cytokines, and the effects of the phytotherapeutic drug, Eviprostat, on these biochemical marker levels and bladder function. Male Sprague-Dawley rats aged 15 weeks were divided into three groups. Arterial injury was experimentally induced by balloon endothelial injury of the iliac arteries, and a 2% cholesterol diet was given for 8 weeks. Rats in the arterial-injury group were given daily oral vehicle or Eviprostat, whereas sham-operated animals on a regular diet (0.09% cholesterol) were given vehicle for the last 2 weeks. Eight weeks after surgery, the levels of bladder pro-inflammatory cytokines, as well as bladder and urinary oxidative-stress markers, were determined. Cystometrograms were carried out without anesthesia or restraint. Bladder and urinary oxidative-stress markers, and bladder pro-inflammatory cytokine levels were significantly increased in the arterial-injury group, and Eviprostat markedly suppressed these increase. The cystometrograms showed that arterial injury decreased the intermicturition interval without affecting the micturition pressure. This decrease was reversed by Eviprostat treatment. Oxidative stress and pro-inflammatory cytokines might be involved in the development of overactive bladder by atherosclerosis-induced chronic bladder ischemia. Eviprostat might provide an attractive treatment option for individuals with bladder dysfunction due to chronic bladder ischemia because of its anti-oxidant and anti-inflammatory properties.

Association of overactive bladder and C‐reactive protein levels. Results from the Boston Area Community Health (BACH) Survey

• To investigate the association between overactive bladder (OAB) and C-reactive protein (CRP) in a population-based sample of men and women. • Epidemiological survey of urological symptoms among men and women aged 30-79 years. A multi-stage stratified cluster design was used to randomly sample 5503 adults from the city of Boston. Analyses were conducted on 1898 men and 1854 women with available CRP levels. • The International Continence Society defines OAB as 'Urgency with or without urge incontinence, usually with frequency and nocturia.' OAB was defined as: (1) urgency, (2) urgency with frequency, and (3) urgency with frequency and nocturia. • Odds ratios (OR) and 95% confidence intervals (95% CI) of the CRP and OAB association were estimated using logistic regression. • Prevalence of OAB increased with CRP levels in both men and women. • In men, adjusted ORs (95% CI) per log(10) (CRP) levels were 1.90 (1.26-2.86) with OAB defined as urgency, 1.65 (1.06-2.58) with OAB defined as urgency and frequency, and 1.92 (1.13-3.28) with OAB defined as urgency, frequency and nocturia. • The association was more modest in women with ORs (95% CI) of 1.53 (1.07-2.18) for OAB as defined urgency, 1.51 (1.02-2.23) for OAB defined as urgency and frequency, and 1.34 (0.85-2.12) for OAB defined as urgency, frequency and nocturia. • Results show a consistent association of increasing CRP levels and OAB among both men and women. • These results support our hypothesis for the role of inflammation in the development of OAB and a possible role for anti-inflammatory agents in its treatment.

Elevation of serum c‐reactive protein in patients with OAB and IC/BPS implies chronic inflammation in the urinary bladder

Chronic inflammation has been implicated in the development of overactive bladder (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS). An elevation of C-reactive protein (CRP) has been associated with chronic inflammation and lower urinary tract symptoms. This study aims to elucidate the association between CRP and OAB or IC/BPS. Serum CRP and urinary nerve growth factor (NGF) levels were examined in 70 patients with OAB (n=22) or IC/BPS (n=48) and compared with 33 normal controls. Data of serum CRP and urinary NGF levels were compared among the controls, IC/PBS, and OAB. The Spearmen correlation analysis test and ANOVA (Kruskal-Wallis) test were used for statistical analysis with P<0.05 considered significant. Serum CRP levels were significantly higher in subjects with OAB (1.83 ± 2.30 mg/L vs. 0.59 ± 0.40 mg/L, P=0.012) or IC/BPS (1.76 ± 3.56 mg/L vs. 0.59 ± 0.40 mg/L, P=0.049) than in controls. No significant difference in CRP level was noted between patients with OAB and IC/BPS (P=0.43). In a subgroup analysis, patients of OAB wet had higher serum CRP level than that of OAB dry (2.95 ± 3.08 mg/L vs. 0.90 ± 0.52 mg/L); however, the difference did not reach statistical significance (P=0.34). The CRP between OAB wet and OAB patients with medical disease was not significantly different. There was no significant correlation between serum CRP and urinary NGF levels in the controls or patients with OAB or IC/BPS, except in the OAB patients with a CRP level >3 mg/L. Our data support the association between chronic inflammation of the urinary bladder in patients with OAB or IC/BPS.

The Management of Voiding Dysfunction following Mid Urethral Tape Insertion

Objective: No standard regimen has been established for the management of postoperative voiding dysfunction following TVT insertion. This study was designed to compare two different strategies for management of this problem. Methods: This is a retrospective study of women operated on within a tertiary referral unit. Two cohorts were identified: those managed by clean intermittent self catheterization (CISC) during 2006, and those managed by ‘pull-down’ of tape in the immediate post-operative period during 2007. Specific measurements include number of patients with resumption of normal voiding and time taken for resolution of symptoms. Incidence of tape division, recurrence of stress incontinence and development of overactive bladder (OAB) were also measured. Results: The incidence of voiding difficulty following TVT insertion remained the same in 2006 and in 2007. 45.5% of the CISC group resumed normal voiding compared to 100% of the ‘pull-down’ group. The incidence of tape division and reappearance of stress incontinence was 54.5% and 27% respectively in the CISC group compared to none in the ‘pull-down’ group. The CISC group also had higher incidence of OAB. Conclusions: Immediate “pull-down” of tape is an effective way of managing voiding dysfunction following TVT with an excellent rate of symptom resolution without any need of further intervention.

4 ASSOCIATION OF OVERACTIVE BLADDER AND C-REACTIVE PROTEIN LEVELS

Introduction and Objectives. Overactive bladder (OAB) is a common problem in aging men and women and has substantial impact on quality of life. Evidence of chronic inflammation in benign prostatic hyperplasia suggests a possible role of inflammation in the development of OAB. The objective of this study was to investigate the association between OAB and C-reactive protein (CRP) levels in a population-based sample of men and women.

Incidence of Overactive Bladder after Vaginal Hysterectomy and Associated Repairs for Pelvic Organ Prolapse

Objective: The aim of this study was to determine the incidence of overactive bladder (OAB) after vaginal hysterectomy for pelvic organ prolapse (POP) and analyze the associated risk factors. Study Design: This was a retrospective cohort study of 217 patients who underwent primary POP vaginal surgery between the years 2000 and 2004 in Donostia Hospital and who did not report OAB before surgery. A personal interview was undertaken after surgery for the diagnosis of OAB, taking into account the ICS 2002 definition. Descriptive statistical analyses and multivariate logistic regression were performed to determine the factors associated with the development of OAB after POP surgery. Results: De novo OAB was diagnosed in 43 (19.8%) patients. The median time at onset of OAB symptoms after surgery was 3 months. Urge urinary incontinence was present in 28 patients (12.9%). Those women operated on also for stress urinary incontinence were at an increased risk for de novo OAB. Conclusion: Nearly 20% of women operated on for POP develop OAB soon after surgery. Those operated on for POP and stress urinary incontinence are more at risk.

Modification of rat detrusor muscle contraction by ascorbic acid and citric acid involving enhanced neurotransmitter release and Ca2+ influx

Consumption of carbonated soft drinks is independently associated with the development of overactive bladder (OR 1.41, 95% Cl 1.02-1.95). We have shown previously that artificial sweeteners, present in carbonated soft drinks, enhanced detrusor muscle contraction. Other constituents of soft drinks are preservatives and antioxidants, we evaluated the effects of two of these, ascorbic acid and citric acid, on the contractile response of isolated rat bladder muscle strips. Detrusor muscle strips were suspended in a perfusion organ bath. We determined the effect of ascorbic acid and citric acid on the contractile responses to electrical field stimulation (EFS) in the absence and presence of atropine, carbachol, alpha, beta methylene ATP, potassium and calcium. Ascorbic acid and citric acid (10(-7) M to 10(-3) M) enhanced the contractile response to 10 Hz EFS compared to control (P < 0.01). The frequency and amplitude of spontaneous bladder contractions were enhanced in the presence of ascorbic acid and citric acid by 14%, 21%, 21%, and 11% respectively. Ascorbic acid 10(-4) M significantly increased the atropine resistant response to EFS 5 Hz by 37% (P < 0.01) and inhibited contraction in response to carbachol 10(-4) M by 24%, (P < 0.05). Both ascorbic acid 10(-4) M and citric acid 10(-5) M significantly enhanced maximum contractile responses to alpha, beta methylene ATP, KCI and calcium compared to control. Ascorbic acid and citric acid augmented bladder muscle contraction possibly by enhanced Ca(2+) influx. Presynaptic neurotransmitter release was enhanced by ascorbic acid. Carbonated beverages containing preservatives may aggravate symptoms of OAB.

Prevalence and Associated Factors of Overactive Bladder in Korean Children 5-13 Years Old: A Nationwide Multicenter Study

To estimate the prevalence of overactive bladder (OAB) in Korean children, 5-13 years of age, and to assess the associated factors for OAB. A randomly selected cross-section study was conducted in 26 kindergartens and 27 elementary schools nationwide in Korea. A total of 19 240 children were included; a parent was asked to complete the questionnaires, which included items about OAB and voiding and defecating habits. OAB was defined as urgency with or without urge incontinence, usually with increased daytime frequency and nocturia (International Children's Continence Society, 2006). Its prevalence and associated factors were also investigated. The response rate for the questionnaires was 85.84%. The overall prevalence of OAB was 16.59%. The prevalence of OAB decreased with age from 22.99% to 12.16% (P = .0001). The overall incidence of wet and dry OAB was 26.97% and 73.03%, respectively. Compared with normal children, those with OAB had a greater prevalence of nocturnal enuresis, constipation, fecal incontinence, urinary tract infection, delayed bladder control, and poor toilet facilities (P < .05). The incidence of increased daytime frequency and urge incontinence was 3.69% and 2.31% (P = .009) and 26.97% and 14.78% (P = .0001) in OAB and non-OAB children, respectively. The corresponding prevalence decreased with age from 5.04% to 3.06% and from 45.74% to 18.50% in OAB children (P = .0001). The overall prevalence of OAB in Korean children, 5-13 years of age, was 16.59% and decreased with age. Nocturnal enuresis, constipation, fecal incontinence, history of urinary tract infection, delayed bladder control, and poor toilet facilities might be factors associated with the development of OAB.

Prevalence and risk factors of overactive bladder syndrome in Fuzhou Chinese women

We randomly sampled a community-based, healthy population to evaluate the prevalence and associated risk factors of overactive bladder (OAB) syndrome by using the International Continence Society (ICS) definition. We randomly sampled 6,066 women (3.0% of registered female residents aged 20 years and older in Fuzhou) and mailed Bristol Female Lower Urinary Tract Symptoms questionnaire for women self-completion. Women (4,684; 77.2%) with evaluable data were included in this study. The prevalence of OAB was 8.0% (n = 377), OAB(dry) 2.4% (n = 114), and OAB(wet) 5.6% (n = 263), hence 30% had OAB(dry) and 70% OAB(wet.) The prevalence of OAB and OAB(wet) demonstrated an significant increasing with advancing age (P < 0.01). A multiple logistic regression analysis showed menopause, parity >2, constipation, episiotomy, and higher BMI were potential risk factors for OAB, constipation increased the occurrence of OAB(dry). OAB(wet) was associated with menopause, parity >2, higher fetal birthweight, episiotomy, while cesarean delivery protected against the development of OAB(wet). The prevalence of OAB in chinese women is lower than that of most reports in Occidental women, and increases with advancing age. Many potential risk factors increase the occurrence of OAB.

The association of diet and other lifestyle factors with the onset of overactive bladder: a longitudinal study in men.

To investigate associations between diet and non-dietary lifestyle factors and the onset of overactive bladder (OAB) in men. Random sample of community-dwelling men aged 40 years plus. Baseline data on urinary symptoms and diet were collected from 5454 men using a postal questionnaire and a food-frequency questionnaire. Follow-up data on urinary symptoms were collected from 4887 men in a postal survey one year later. Logistic regression analysis was used to investigate diet and lifestyle factors associated with onset of OAB in the men without OAB at baseline. There was a highly significant negative association between beer intake at baseline and subsequent OAB onset (P=0.001), with reduced risk at all levels of intake compared with those who seldom/never drank beer. Adjustment for total alcohol intake (g ethanol day(-1)) reduced the significance of the association (P=0.02). None of the food groups studied was associated with OAB onset, with the possible exception of potatoes (P=0.05), which showed an increased risk of onset at the highest level of consumption. Physical activity, smoking and obesity were not significantly associated. While most diet and lifestyle factors were not associated with OAB onset, the evidence from this prospective longitudinal study suggests that beer may have a protective role in the development of OAB. This could be due to a non-alcoholic ingredient as well as the alcohol content.

Nutrient composition of the diet and the development of overactive bladder: a longitudinal study in women.

Evidence for an association between diet and the symptom syndrome overactive bladder (OAB) would be valuable in understanding its aetiology. The present study investigates prospectively the association between the nutrient composition of the diet and the onset of OAB. A random sample of community dwelling women aged 40 years or over was studied. Baseline data on urinary symptoms and diet were collected from 6,371 women using a postal questionnaire and food frequency questionnaire. Follow-up data on urinary symptoms were collected from 5,816 of the women in a postal survey 1 year later. Logistic regression was used to investigate the association of diet (daily intakes of energy, macro and micronutrients) with 1 year incidence of OAB. There was evidence that three nutrients may be associated with OAB onset. Higher intakes of vitamin D (P = 0.008), protein (P = 0.03), and potassium (P = 0.05) were significantly associated with decreased risks of onset. Although overall the associations with vitamin B6 and niacin were not significant (P = 0.08 and P = 0.13), there was some evidence of a decreased risk of onset with higher intakes. The results from this prospective study suggest possible aetiological associations between certain nutrients and OAB onset. The findings need confirmation and possible mechanisms to explain these associations need further investigation.