Severity Of Overactive Bladder Research Articles

Effect of vitamin-D and other factors on the presence and severity of urinary incontinence and overactive bladder in elderly individuals

Objective: This study aimed to investigate the effect of serum vitamin D levels on urinary incontinence and overactive bladder in elderly individuals. Methods: The study included 106 elderly individuals who had their serum vitamin D levels measured in the past year. Sociodemographic characteristics, habits, medical histories, medications used, height, and weight data were collected. The ICIQ-UI short form and Overactive Bladder-V8 form were adminis-tered. Participants were grouped based on their vitamin D levels. Results: Among participants, 17.9% had severe vitamin D deficiency, 28.3% had vitamin D deficiency, 18.9% had vitamin D insufficiency, and 34.9% had normal vitamin D levels. No significant association was found between vitamin D levels and the presence of urinary incontinence and overactive bladder. When participants were grouped by vitamin D levels, there was no significant difference in the presence of urinary incontinence and overactive bladder among the groups. However, a significant difference was found in the severity of overactive bladder. Individuals with normal vitamin D levels had significantly higher rates of urinary incontinence and overactive bladder compared to those with lower levels. Conclusion: Urinary incontinence increases with age and may be associated with aging-related comor-bidities. Although reports in the literature suggest a relationship between vitamin D deficiency and urinary incontinence and overactive bladder, this relationship was not confirmed in our study. This discrepancy may be due to differences in the characteristics of the populations studied in the literature.

Risk factors associated with overactive bladder severity in patients with type 2 diabetes.

The prevalence of overactive bladder (OAB) is known to be higher in patients with type 2 diabetes (T2DM) however there are not many studies about specific risk factors contributing to its progression among diabetes mellitus (DM) patients, so this study aimed to investigate the risk factors specific to DM that influence the progression of OAB in Syrian population. This cross-sectional study was carried out at five endocrinology centers situated in four Syrian provinces: Damascus, Aleppo, Homs, Hama, and Latakia. The study comprised patients who were diagnosed with both T2DM and OAB and had visited these centers from March 2020 and February 2024. The Arabic version of the OAB Symptom Score (OABSS) scale was used to categorize the participants based on the severity score into two groups: the mild OAB group and the moderate-severe OAB group. A logistic analysis was conducted to assess the risk factors associated with the progression of OAB among patients with diabetes. Among the 186 patients diagnosed with both DM and OAB, significant distinctions were found between the two groups concerning the severity of OAB, age, duration of diabetes, symptomatic diabetic peripheral neuropathy (DPN), and ankle reflex (p < 0.05). Furthermore, a multivariate analysis revealed that age (odds ratio [OR] 1.07, 95% confidence interval [CI] 0.68-1.58), duration of diabetes (OR 2.14, 95% CI 1.75-3.74), and symptomatic DPN (OR 2.47, 95% CI 1.17-3.54) independently acted as risk factors for the advancement of OAB. The progression of OAB in Syrian patients with diabetes is closely associated with the severity of DM. Factors such as age, duration of diabetes, and symptomatic DPN are independent predictors of the severity of OAB. Patients who experience symptomatic DPN are at an increased risk of developing OAB.

Risk factors associated with the severity of overactive bladder among Syrian patients with type 2 diabetes

The prevalence of overactive bladder (OAB) is known to be higher in patients with type 2 diabetes (T2DM). However, few studies have examined specific risk factors contributing to its progression among diabetes mellitus (DM) patients, so this study aimed to investigate the risk factors specific to diabetes mellitus that influence overactive bladder in the Syrian population. This cross-sectional study was conducted at four endocrinology centers in four Syrian provinces: Damascus, Aleppo, Homs, Hama, and Latakia. The study was comprised of patients who had been diagnosed with both T2DM and OAB and had visited these centers from February 2020 to January 2023. The Arabic version of the Overactive Bladder Symptom Score (OABSS) scale was used to categorize the participants based on the severity score into two groups: the mild OAB group and the moderate-severe OAB group. A logistic analysis was conducted to assess the risk factors associated with the OAB among patients with diabetes. Among the 153 patients diagnosed with both DM and OAB, significant distinctions were found between the two groups concerning the severity of overactive bladder, age, duration of diabetes, symptomatic diabetic peripheral neuropathy (DPN), and ankle reflex (P < 0.05). Furthermore, a multivariate analysis revealed that age (OR 1.48, 95% CI 0.89–2.19), duration of diabetes (OR 1.94, 95% CI 0.53–2.23), and symptomatic DPN (OR 2.74, 95% CI 1.39–4.13) independently acted as risk factors for the advancement of OAB. The severity of OAB in Syrian patients with diabetes is closely associated with the severity of DM. Factors such as age, duration of diabetes, and symptomatic DPN are independent predictors of the severity of OAB. Patients who experience symptomatic DPN are at an increased risk of developing OAB.

A high salt diet impairs the bladder epithelial barrier and activates the NLRP3 and NF‑κB signaling pathways to induce an overactive bladder in vivo.

Overactive bladder (OAB) is a condition characterized by an urgency to urinate, which is associated with the urodynamic observation of detrusor overexcitation. Although the etiology of OAB is currently unclear, it has been suggested that in patients with OAB, disruption of bladder epithelial barrier integrity can disturb the normal contractile function of the detrusor. Additionally, dietary preferences have been suggested to influence the severity of OAB. Therefore, the aim of the present study was to investigate the effect of a high salt diet (HSD) on the development of OAB in a murine model. Mice were fed either a HSD or standard diet for 8 weeks, following which voiding characteristics and bladder barrier function were assessed. The present study demonstrated that a HSD in mice was associated with OAB-like symptoms such as increased urinary frequency and non-voiding bladder contractions. The HSD group demonstrated a thinner bladder mucus layer and decreased expression of bladder barrier markers, tight junction protein-1 and claudin-1, which may be potentially indicative of induced bladder damage. A HSD for 8 weeks in mice and a high salt treatment at the uroepithelium cellular (SV-HUC-1s) level resulted in increased uroepithelial oxidative stress and inflammatory cell infiltration, as indicated by increased expression levels of TNF-α and IL-1β, as well as activation of the nucleotide-binding domain leucine-rich-containing family pyrin domain-containing 3 (NLRP3) and NF-κB signaling pathways in vivo and in vitro. Therefore, the present study indicated that a HSD could be a potentially important risk factor for the development of OAB, as it may be associated with overactivation of contractile function of the bladder by impairing the integrity of the bladder epithelial barrier and activation of the NLRP3 and NF-κB signaling pathways. Remodeling of the bladder barrier and reduction of the inflammatory response may be potential targets for the treatment of OAB in the future.

Post-stroke urinary incontinence is associated with behavior control deficits and overactive bladder

BackgroundAlthough urinary incontinence in stroke survivors can substantially impact the patient's quality of life, the underlying neuropsychological mechanisms and its neural basis have not been adequately investigated. Therefore, we investigated this topic via neuropsychological assessment and neuroimaging in a cross-sectional study. MethodsWe recruited 71 individuals with cerebrovascular disease. The relationship between urinary incontinence and neuropsychological indices was investigated using simple linear regression analysis or Mann-Whitney U test, along with other explanatory variables, e.g., severity of overactive bladder. Variables with a p-value of <0.1 in the simple regression analysis were entered in the final multiple linear regression model to control for potential confounding factors. To carry out an in-depth examination of the neuroanatomical substrate for urinary incontinence, voxel-based lesion-behavior mapping was performed using MRIcron software. ResultsBehavioral control deficits and severity of overactive bladder were closely related to severity of urinary incontinence. The voxel-based lesion-behavior mapping suggests a potential role for ventromedial prefrontal cortex lesioning in the severity of urinary incontinence, although this association is not statistically significant. ConclusionsPost-stroke urinary incontinence is closely related to two factors: neurogenic overactive bladder, a physiological disinhibition of micturition reflex, and cognitive dysfunction, characterized by behavior control deficits.

Resolution of Overactive Bladder Symptoms After Anterior and Apical Prolapse Repair.

Patients often present with both overactive bladder (OAB) and pelvic organ prolapse (POP) concerns. It is unknown whether treatment of POP improves OAB. This study aimed to evaluate whether OAB improves after anterior/apical POP repair for anterior wall prolapse. This was a prospective study of women with anterior/apical prolapse at or beyond the hymen and concomitant OAB symptoms, undergoing apical repair. Overactive bladder severity was evaluated with the Urogenital Distress Inventory-6 (UDI-6) questionnaire and the Incontinence Impact Questionnaire-7 preoperatively and 2, 6, 12, and 24 weeks postoperatively. The primary outcome was a reduction of ≥11 points or greater on the UDI-6 at 6 months. Those who reported an ≥11-point reduction were termed responders. Multivariable regression analyses were performed to evaluate factors associated with reduction in OAB symptoms after POP surgery. A total of 117 patients met the criteria for analysis, with 79.5% reporting improved OAB symptoms after POP repair at 6 months. There were no preoperative differences between groups. The mean preoperative UDI-6 and Incontinence Impact Questionnaire-7 scores were higher in the responder group (51.1 ± 16.8 vs 26.4 ± 15.1 [P < 0.001] and 44.6 ± 23.8 vs 22.8 ± 21.4 [P = 0.001], respectively), and the presence of detrusor overactivity was lower (29.0% vs 54.2%, P = 0.02). After regression, a higher preoperative UDI-6 total was associated with an increased likelihood of symptom improvement at 6 months (adjusted odds ratio, 1.14 per point [1.08-1.19]), whereas detrusor overactivity on preoperative urodynamics was associated with a decreased likelihood of OAB symptom improvement (adjusted odds ratio, 0.10 [0.02-0.44]). Overactive bladder symptoms improve in the majority of patients undergoing apical repair for anterior/apical prolapse beyond the hymen.

Relationship Between Overactive Bladder and Bone Fracture Risk in Female Patients.

Overactive bladder (OAB) has recently been recognized as an independent risk factor for falls and fractures. This study aimed to predict fracture risk in female patients with OAB symptoms. We assessed and compared the fracture risk in newly diagnosed female patients with OAB to those without OAB using the Fracture Risk Assessment Tool (FRAX), and investigated the relationship between fracture risk and OAB severity. The present single-center, cross-sectional study included 177 female participants (79 with OAB, 98 without OAB). The OAB group was older (p=0.033) and shorter (p=0.010) compared to the non-OAB group. Compared to the non-OAB group, the OAB group had more patients with hypertension (p<0.001) and diabetes mellitus (p=0.011), as well as higher risks for major fractures (non-OAB group: 15.2±13.2%; OAB group: 23.6±14.1%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%; OAB group: 10.6±10.0%; p=0.007). In addition, those with moderate/severe OAB had the most significantly elevated risks for both major fractures (non-OAB group: 15.2±13.2%, mild-OAB: 17.6±12.5%, moderate/sever-OAB: 26.4±14.0%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%, mild-OAB: 6.5±7.6%, moderate/sever-OAB: 12.5±10.4%; p<0.001). Among the OAB symptoms, nocturia had the strongest correlation with fracture risk (major fracture, ρ=0.534; hip fracture, ρ=0.449; all p<0.001). Patients with severe OAB, and particularly severe nocturia, should be closely monitored with timely and aggressive symptom management; however, an interventional study incorporating the management of OAB symptoms is required to confirm whether the proactive management of OAB symptoms reduces the risk of fractures in older females.

Psychometric Properties and Cutoff Value of the Turkish Overactive Bladder Symptom Score.

The Overactive Bladder Symptom Score (OABSS) measures all overactive bladder (OAB) symptoms with graded answers, evaluates urgency symptoms, and reveals the subjective bladder control. However, the Turkish version and the cutoff value of the questionnaire have not yet been studied. The aims of this study were to determine the psychometric properties of the 7-item OABSS and to estimate the cutoff value of the scale. This was an observational study. The internal consistency (Cronbach α) and test-retest reliability were analyzed, and exploratory factor analysis was performed. For the criterion validity, the correlations between the OABSS, the Overactive Bladder Questionnaire, the Bristol Female Lower Urinary Tract Symptoms questionnaire, and outcomes of a bladder diary were used. The cutoff value of the OABSS was analyzed by the receiver operating characteristics curve analysis. Participants with (n = 49) and without (n = 38) OAB were included. The internal consistency was very strong (Cronbach α = 0.95). The test-retest reliability was very strong (intraclass correlation coefficients = 0.93-0.95, P = 0.001). The percentage of explanation of the total variance was calculated as 78%. There was a strong to very strong correlation between the OABSS and the Overactive Bladder Questionnaire and Bristol Female Lower Urinary Tract Symptoms scores and outcomes of the bladder diary. The cutoff value for the OABSS was determined as 10.5. The Turkish OABSS was found to be a valid and reliable scale to determine OAB symptoms and severity. Those who score more than 10.5 on the questionnaire can be considered as at risk of OAB syndrome.

Associations between overactive bladder and sleep patterns: a cross-sectional study based on 2007–2014 NHANES

Abstract Objectives To determine whether relationship exists between overactive bladder (OAB) and sleep patterns through the cross-sectional study. Patients and methods Patients from the National Health and Nutrition Examination Survey (NHANES) 2007–2014 were included in this study. Data were extracted through questionnaires, including demographics, dietary and health-related behaviors, body measurements and disease information. Three sleep factors were included to aggregate overall sleep scores, ranging from 0 to 3. A sleep score of 0 to 1, 2 or 3 was expressed as a bad, intermediate or healthy sleep pattern, respectively. The Overactive Bladder Symptom Score (OABSS) scale was applied to quantify the severity of OAB for each participant. Weighted logistic regression models were used to investigate the associations between sleep and OAB. Results A total of 16,978 participants were enrolled in this study. The relationship between OAB and sleep patterns was statistically significant. After fully adjusting for confounding factors, the OAB risk of patients with intermediate and poor sleep patterns obviously increased by 26% and 38%, respectively, and mild (OR = 1.21, 95% CI [1.03,1.42]), moderate (OR = 1.45, 95% CI [1.27,1.66]) and severe (OR = 1.57, 95% CI [1.18,2.09]) OAB were significantly associated with sleep pattern grouping. The prevalence of OAB is significantly higher in patients with bad sleep patterns, and vice versa. Conclusion This study indicated that there is a positive relationship between OAB and worse sleep-related issues.

The Assessment of the Efficacy of Imperatorin in Reducing Overactive Bladder Symptoms

Overactive bladder syndrome (OAB) is a prevalent condition that affects the elderly population in particular and significantly impairs quality of life. Imperatorin, a naturally occurring furocoumarin, possesses diverse pharmacological properties that warrant consideration for drug development. The aim of this study was to investigate the potential of imperatorin (IMP) to attenuate the cystometric and biochemical changes typically associated with retinyl acetate-induced overactive bladder (OAB) and to assess its viability as a pharmacological intervention for OAB patients. A total of 60 rats were divided into four groups: I—control, II—rats with rapamycin (RA)-induced OAB, III—rats administered IMP at a dose of 10 mg/kg/day, and IV—rats with RA-induced OAB treated with IMP. IMP or vehicle were injected intraperitoneally for 14 days. The cystometry and assessment of bladder blood flow were performed two days after the last dose of IMP. The rats were then placed in metabolic cages for 24 h. Urothelial thickness measurements and biochemical analyses were performed. Intravesical infusion of RA induced OAB. Notably, intraperitoneal administration of imperatorin had no discernible effect on urinary bladder function and micturition cycles in normal rats. IMP attenuated the severity of RA-induced OAB. RA induced increases in urothelial ATP, calcitonin gene-related peptide (CGRP), organic cation transporter 3 (OCT3), and vesicular acetylcholine transporter (VAChT), as well as significant c-Fos expression in all micturition areas analyzed, which were attenuated by IMP. Furthermore, elevated levels of Rho kinase (ROCK1) and VAChT were observed in the detrusor, which were reversed by IMP in the context of RA-induced OAB in the urothelium, detrusor muscle, and urine. Imperatorin has a mitigating effect on detrusor overactivity. The mechanisms of action of IMP in the bladder appear to be diverse and complex. These findings suggest that IMP may provide protection against RA-induced OAB and could potentially develop into an innovative therapeutic strategy for the treatment of OAB.

Overactive Bladder in Late Pregnancy to 1 Year After First Vaginal Delivery.

Understanding overactive bladder (OAB) during pregnancy and postpartum may increase our knowledge of pathophysiology. The purpose of this study was to understand the prevalence and severity of OAB during pregnancy through 1 year postpartum as well as the associated factors. This is a secondary analysis of a prospective cohort study evaluating primiparous women with a singleton term vaginal delivery assessed at the third trimester, 8 weeks postpartum, and 1 year postpartum. Overactive bladder was defined as urinary urgency plus nocturia or frequency, or urgency urinary incontinence (UUI). Overactive bladder severity was defined using average visual analog scores (0-100) from OAB symptoms on the Epidemiology of Prolapse and Incontinence Questionnaire. We evaluated associations with OAB at each time point using logistic regression. Among 579 participants, mean age was 29 years. Overactive bladder prevalence was higher at 8 weeks postpartum (23%) than at the third trimester (18%, P = 0.03) and 1 year postpartum (19%, P = 0.03). Overactive bladder severity was higher at the third trimester (42.2) than at 8 weeks postpartum (23.3, P = 0.008), but not at 1 year postpartum (29.1, P = 0.1). In those with OAB, UUI severity was higher at 1 year postpartum compared with that at the third trimester ( P = 0.02). Younger age was associated with third trimester OAB. At 8 weeks postpartum, OAB was associated with older age, urinary tract infection after delivery, birth weight ≥3,500 g, and third trimester OAB. At 1 year postpartum, OAB was associated with birth weight ≥3,500 g and third trimester OAB. Overactive bladder affects 1 in 5 primiparous women during pregnancy or after vaginal delivery. The increased severity of UUI postpartum and the association between higher birth weight and OAB postpartum suggest an effect of delivery.

Overactive bladder and multiple sclerosis in the University Hospital of Oujda

BackgroundMultiple sclerosis (MS) is the most frequent autoimmune neurological disease in the young population. Vesico-sphincter disorders are frequent in the course of the disease; it has been reported that 90% of MS patients will develop a lower urinary tract disorder within 18 years of the diagnosis.MethodsThe aim of this study is to identify the frequency, severity, diagnosis, and treatment of overactive bladder (OAB) in MS patients at the Mohammed VI hospital university in Oujda-Morocco. It is a cross-sectional study. The population was collected in neurology department of Mohammed VI hospital university in Oujda-Morocco. The population cohort consisted of patients diagnosed with multiple sclerosis, which were invited to the urology department where they underwent urinary screening and completed a form of questions regarding the frequency and severity of OAB and its influence on quality of life.ResultIn our study, the mean age of the patients was 43 years, and our sample was composed of 48% males and 52% females, and the most frequent lower urinary tract symptom was urgency (57%), followed by urinary frequency (29%) and urge incontinence (14%). The recurrent-remittent form was the most frequent (62%), followed by the primary progressive form (24%) and the secondary progressive recurrent form (14%). Among the patients, 33% presented a mild symptomatology, 48% moderate, and 19% severe. In this study, it was found that the intensity of urinary symptoms and the MS disability score were positively correlated with quality of life and disease duration.ConclusionThe urgency was the major symptom of the lower urinary tract, and the MS disability score and the severity of OAB were associated with the quality of life of the patients. The urological evaluation of patients with multiple sclerosis should be performed routinely to identify OAB and to treat this condition appropriately.

PD33-09 SIGNIFICANCE OF SUBJECTIVE SYMPTOM SEVERITY AND ASSESSMENT OF FRACTURE RISK USING PREDICTIVE TOOLS IN PATIENTS WITH OVERACTIVE BLADDER

You have accessJournal of UrologyCME1 Apr 2023PD33-09 SIGNIFICANCE OF SUBJECTIVE SYMPTOM SEVERITY AND ASSESSMENT OF FRACTURE RISK USING PREDICTIVE TOOLS IN PATIENTS WITH OVERACTIVE BLADDER Tomohiro Matsuo, Ken Kawada, Yasufumi Ueda, Kensuke Mitsunari, Kojiro Ohba, and Ryoichi Imamura Tomohiro MatsuoTomohiro Matsuo More articles by this author , Ken KawadaKen Kawada More articles by this author , Yasufumi UedaYasufumi Ueda More articles by this author , Kensuke MitsunariKensuke Mitsunari More articles by this author , Kojiro OhbaKojiro Ohba More articles by this author , and Ryoichi ImamuraRyoichi Imamura More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003326.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Lower urinary tract symptoms (LUTS) are an independent risk factor for falls and fractures.In clinical practice, frail older LUTS patients sustain falls and fractures caused by their activities of daily living. This often leads to life-threatening events from the progression of weakness. Although LUTS per se may sometimes be a vital prognostic factor, there have been no clinical studies to predict fractures in LUTS patients.The World Health Organization developed the Fracture Risk Assessment Tool (FRAX) as “a tool for calculating the risk of fractures over the next 10 years.” FRAX is a 12-item fracture prediction screening tool that includes age, sex, smoking cessation, history of steroid therapy, comorbidities, and history of fractures that can be calculated. It is also useful for screening for hip and major fractures, not only for those with osteoporosis but also for healthy patients.Our study aimed to estimate the risk of fracture in patients with overactive bladder (OAB) using FRAX, particularly those with LUTS, and to investigate the association between individual OAB symptoms and fracture risk. METHODS: Subjects with de novo OAB and age-matched controls were enrolled, and between-group differences in bone fracture risk using the FRAX were analyzed. Severity assessment was performed using the OAB symptom score (OABSS), with OAB patients scoring ≥2 on item Q3 (urgency) and a total of ≥3. Bone fracture risk was analyzed in cases grouped based on OAB severity (non-OAB, mild-OAB [OABSS≤5) and moderate/severe-OAB [OABSS≥6]). RESULTS: This study included 324 patients: 122 in the OAB (O) group and 202 in the non-OAB (N) group. The O group had significantly higher major fracture risk in the next 10 years (O: 19.5±13.2%; N: 11.7±10.3%; p<0.001), and risk of hip fracture (O: 8.8±8.9%; N: 4.8±8.0%; p<0.001) than the N group. All four question items on OABSS and the total scores were significantly positively correlated with the risk of major fractures. Q2 (nocturia) was the most strongly correlated (r=0.401, p<0.001). The relationship between risk of hip fracture and OABSS was similar (Q2: r=0.372, p<0.001).The moderate/severe-OAB group had the highest risk of major fractures (non-OAB: 11.7±10.3%; mild-OAB: 15.5±10.9%; moderate/severe-OAB 21.5±13.9, p<0.001), and the risk of hip fracture (non-OAB: 4.8±8.0%; mild-OAB: 6.5±7.2%; moderate/severe-OAB: 10.0±9.5, p<0.001) was the highest. CONCLUSIONS: OAB patients had a higher fracture risk than non-OAB patients, and the risk of fracture was also associated with the severity of OAB. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e917 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tomohiro Matsuo More articles by this author Ken Kawada More articles by this author Yasufumi Ueda More articles by this author Kensuke Mitsunari More articles by this author Kojiro Ohba More articles by this author Ryoichi Imamura More articles by this author Expand All Advertisement PDF downloadLoading ...

The biopsychosocial impacts of anxiety on overactive bladder in women.

Links between emotional state and the bladder have long been recognized, as psychological comorbidity is a common feature of overactive bladder (OAB). However, how psychological factors might contribute to the development and severity of OAB remains unclear. Therefore, we sought to examine the effect of anxiety on OAB with a specific focus on bladder hypersensitivity. In a sample of 120 adult women with OAB, we compared those with at least mild anxiety (PROMIS Anxiety score ≥55) to those with lower anxiety. Analyses focused on patient-reported questionnaires assessing urinary symptom severity and quality of life, psychological stress symptoms, general somatic symptoms, and results of quantitative sensory testing (QST), including temporal summation to heat pain (TSP). TSP was used to index elevated C-fiber responsiveness (i.e., central sensitization). Thirty-six (30%) women had at least mild anxiety. While there were no group differences for urinary symptom severity, more anxious women reported worse OAB-specific quality of life, greater psychological stress burden, higher stress reactivity, and greater somatic symptoms. On QST, there were no differences between anxiety groups for pain threshold (43.6 ± 3.1°C vs. 44.0 ± 3.1°C, p = 0.6) and tolerance (47.3 ± 1.5°C vs. 47.4 ± 1.6°C, p = 0.7). However, those with anxiety had significantly higher TSP than those without anxiety (6.0 ± 4.8 vs. 3.7 ± 3.9, p = 0.006), indicating greater central sensitization. Women with OAB and at least mild anxiety symptoms reported greater psychosocial burdens (i.e., psychological stress, stress reactivity, OAB-specific QOL) and somatic symptom severity and demonstrated greater central sensitization on QST than those without anxiety. These findings support the hypothesis that anxiety and psychological stress impact hypersensitivity mechanisms that may underlie and contribute to OAB, although further research is needed to better understand how and to what extent.

Translation and Validation of the Overactive Bladder Symptom Score (OABSS) in Chinese during the COVID-19 Telehealth Surge

Overactive bladder (OAB) is a prevalent disease that may affect up to 16% of the population. Barriers to health care exist in the Chinese patient population due to language and cultural differences. Our aim was to create a validated Chinese Overactive Bladder Symptom Score (OABSS) which could capture the full range of OAB symptoms, quantify OAB severity, and be administered both in the clinic and remotely in the wake of the telehealth surge during COVID-19. The English version of the OABSS was translated into Chinese. The 5th question in the survey served as a proxy for OAB status (OAB-positive and OAB-negative). A hybrid and remote model were created in our translation and validation efforts. In the hybrid model, patients were seen in clinic and called over the phone to readminister the survey. In the remote model, patients were called twice to administer the survey. Internal validity was calculated using Cronbach’s coefficient alpha, test-retest reliability was measured using Spearman’s correlation, and t-test was used to assess discriminant validity between groups and between visits. A total of 63 patients and 73 patients were included in the final analysis of the hybrid and remote models, respectively. An acceptable degree of internal validity was appreciated in both hybrid and remote models by Cronbach’s alpha score of 0.79 and 0.75, respectively. There were strong associations between responses from visit 1 to visit 2 in both models. Spearman’s coefficients ranged from 0.43 to 0.91, with all 7 questions and total OAB score showing statistically significant associations (p<0.001). In both models, no significant differences in total OAB score were seen between visits 1 and 2 in both OAB-positive and OAB-negative groups. However, the OAB-positive group had significantly higher mean OAB scores in both visits 1 and 2 compared to the OAB-negative group. Through several methods of determining survey validity, the Chinese version of the OABSS proved to be a useful tool in assessing OAB severity and gives providers an opportunity to assess Chinese speaking patients remotely. As telehealth visits increase in frequency, OAB symptoms can continue to be monitored adequately.

The detection of urinary viruses is associated with aggravated symptoms and altered bacteriome in female with overactive bladder.

Although it is known that changes in bacterial components of the urinary microbiome are associated with overactive bladder (OAB), the specific role of viruses is still insufficiently investigated. The aim of the present study is to evaluate the role of urinary viruses in woman with OAB, and analyze the potential relationship between viruses, bacteria and disease. Catheterized urine samples were collected from 55 women with OAB and 18 control individuals. OAB patients fulfilling the following criteria were considered eligible for this study: female, 18 years of age or older; presented with classic OAB symptoms defined by the International Continence Society; and OAB Symptom Score (OABSS) total score ≥ 3 points and question 3 (urgency) score ≥ 2 points. Based on results of metagenomic next-generation sequencing (mNGS), all participants were divided into virus-infected and virus-uninfected groups for analysis. The results of mNGS showed that the diversity of the OAB group was lower than that of the control group when focused on bacterial sequences, which was consistent with our previous study. According to the questionnaire filled out by the patients, OABSS and 8-item OAB questionnaire, female OAB patients who had viruses detected in their urine had more severe symptoms. In parallel, John Cunningham virus (mainly subtype 7 and subtype 2) was the most frequently detected virus in urine. Correlation analysis indicated that risk factors for virus infection in OAB patients include age, habit of holding urine and pelvic surgery history. Given our preliminary data, viral infection can aggravate OAB severity and affect the composition of bacterial. Further research is required to explain how viral infections can aggravate OAB patient symptoms and cause bacterial changes.

Relationship Between Marijuana Use and Overactive Bladder (OAB): A Cross-Sectional Research of NHANES 2005 to 2018

BackgroundCurrent research is starting to focus on the medical value of marijuana and the possible health problems it can cause. Previous studies have shown that marijuana can relieve lower urinary tract symptoms, which can pose a significant public health burden. In this study, we assessed the association between regular marijuana use and overactive bladder as part of low urinary tract symptoms. MethodsData from the National Health and Nutrition Examination Survey 2005-2018 were obtained for analysis. The Overactive Bladder Symptom Score scale was used to define the presence of overactive bladder for each participant. Multivariate logistic regression and ordinal logistic regression were used to analyze the association of marijuana use with the onset and severity of overactive bladder, respectively. ResultsWe found that approximately 24% of the US population reported regular marijuana use. Compared with nonregular users, regular marijuana users were younger, thinner, more likely to be male, smokers, low-income, less educated, unmarried, and non-Hispanic White/Black. Multivariate logistic regression revealed that marijuana exposure may be an independent risk factor for overactive bladder (odds ratio 1.39; 95% confidence interval, 1.16-1.66). Ordinal logistic regression results showed that marijuana exposure was associated with the severity of overactive bladder (odds ratio 1.45; 95% confidence interval, 1.30-1.60). Moreover, all frequencies of regular use showed almost consistent effects on the onset and severity of overactive bladder. ConclusionRegular marijuana use may increase the risk of overactive bladder. Our data do not support the evidence for the use of cannabinoids in the medical treatment of patients with overactive bladder, especially given the thorny health problems caused by marijuana.

The association between overactive bladder and fibromyalgia: A systematic review and meta-analysis.

Overactive bladder is a common syndrome that significantly affects the quality of life. Fibromyalgia is characterized by widespread pain, impacting patients' lives. The exact mechanisms of the two syndromes remain unknown, but there is an overlap between the suspected pathophysiologies. To present an overview of the current research on the association between overactive bladder (OAB) and fibromyalgia. A systematic search of four electronic databases was conducted. Studies examining the correlation between OAB and fibromyalgia with female patients aged over 18 years were included. Two reviewers screened the studies for eligibility. Eligible studies were screened for quality. A meta-analysis was performed for eligible studies. Seven studies were included in the final review, of which six presented a positive association between the syndromes. The studies demonstrated a positive association between fibromyalgia and the severity of OAB and an adverse effect on the quality of life related to OAB. A mean effect size of 1.96 (95% confidence interval 0.85-3.06) was calculated. OAB and fibromyalgia are both complex and multifactorial syndromes. The study presents an association between them, but additional studies on the topic should be conducted for a more precise conclusion.

Health disparities and access to advanced therapy for overactive bladder

Refractory overactive bladder (OAB) is among the most common reasons for referral to specialists in voiding dysfunction. Significant racial and ethnic disparities exist in prevalence, severity, and management of OAB, presenting care barriers for marginalized patients. We aim to explicate these disparities and explore the factors that led to their existence and persistence. We will additionally offer suggestions to mitigate such disparities and approach equitable care for our patients. This is a narrative review of pertinent articles related to health disparities in OAB. Articles on OAB prevalence stratified by race and ethnicity, and variations in treatment patterns for patients of marginalized backgrounds were identified from the PubMed database. We also included a review of evidence from governmental and historical sources to provide sociocultural context. Patients from marginalized backgrounds are underrepresented in OAB literature. There appear to be differences in symptom severity and prevalence based on race. OAB severity seems closely entwined with social determinants of health. Patients from marginalized populations experience numerous care barriers impeding the treatment of OAB. Finally, White patients are more likely to receive advanced management for OAB. Numerous health disparities exist in the diagnosis and management of OAB. This review is grounded in societal context: health injustice in the United States ultimately stems from systemic racism. Improving our understanding of care disparities and the systems that allow them to persist will bring us closer to equity and allow our patients from marginalized backgrounds to obtain the evidence-based care they deserve.

PD38-05 EXCESSIVE VISCERAL FAT IN MEN IS ASSOCIATED WITH THE PRESENCE AND SEVERITY OF OVERACTIVE BLADDER

You have accessJournal of UrologyCME1 May 2022PD38-05 EXCESSIVE VISCERAL FAT IN MEN IS ASSOCIATED WITH THE PRESENCE AND SEVERITY OF OVERACTIVE BLADDER Tomohiro Matsuo, Yasuyoshi Miyata, Hidenori Ito, Hiroki Kurata, Masahito Masato, Kensuke Mitsunari, Kojiro Ohba, and Hideki Sakai Tomohiro MatsuoTomohiro Matsuo More articles by this author , Yasuyoshi MiyataYasuyoshi Miyata More articles by this author , Hidenori ItoHidenori Ito More articles by this author , Hiroki KurataHiroki Kurata More articles by this author , Masahito MasatoMasahito Masato More articles by this author , Kensuke MitsunariKensuke Mitsunari More articles by this author , Kojiro OhbaKojiro Ohba More articles by this author , and Hideki SakaiHideki Sakai More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002596.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Increased abdominal visceral fat induces abnormal adipocytokine secretion. This leads to overproduction of various inflammatory cytokines, which induce systemic chronic inflammation and can result in metabolic syndrome (MetS). Although it is understood that systemic inflammation spread due to MetS can cause various lifestyle diseases, it was recently reported that MetS is also an important factor in lower urinary tract symptoms (LUTS), including overactive bladder (OAB). A recent study of women showed that excessive visceral fat accumulation, which triggers MetS, is related to OAB presence and severity. However, there has been no such research on men, who are considered more susceptible to the effects of visceral fat than women. Therefore, the objective of this study was to clarify the relationship between visceral fat volume and OAB in men. METHODS: Men who underwent abdominal CT as part of health checks and had not been treated for LUTS before the study were included. OAB was defined as scoring ≥2 points on question 3 (urinary urgency) of the Overactive Bladder Symptom Score (OABSS) and a total score of ≥3 points. Visceral fat area (VFA), visceral fat volume (VFV), and total abdominal fat volume (TAV) calculated from abdominal CT, the presence of OAB, associations between these fat parameters; and OABSS total score were examined. Visceral fat was measured using a 3-dimensional image analysis system (SYNOSE VINCENT®, FUJIFILM Corporation, Tokyo, Japan). RESULTS: There were 519 participants in the analysis set. The mean age was 57.4±15.2 years. There were 135 patients (26.0%) who met the criteria for OAB. From the abdominal CT results, the OAB group exhibited statistically and significantly higher values than the non-OAB group for the following factors: VFA (non-OAB; 72.1±39.6 cm2, OAB; 113.5±72.2 cm2, P<0.001), VFV (non-OAB; 1829.1±1249.6 cm3, OAB; 3299.6±2380.2 cm3, P<0.001), and VFV/TAV (non-OAB; 0.32±0.12, OAB; 0.50±0.15, P<0.001). When correlations between these factors obtained from the image findings and the OABSS total score were examined, VFV/TAV had the strongest correlation with the OABSS total score (r=0.511, P<0.001). The area under the receiver operating characteristic curve for the presence of OAB and VFV/TAV was 0.821. At a cutoff value of 0.409, the sensitivity and specificity were 0.741 and 0.732, respectively. Multivariate analysis of VFV/TAV and factors contributing to OAB, such as age, prostate volume, hypertension, and diabetes, showed that high VFV/TAV (≥0.409) was an independent risk factor for OAB in univariate and multivariate analyses (odds ratio 4.51, 95% confidence interval: 2.57-7.89, P<0.001). CONCLUSIONS: We found that VFA and increased VFA were closely associated with OAB presence and severity in men. The results also indicated that excessive abdominal visceral fat accumulation itself is an important risk factor for OAB. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e647 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tomohiro Matsuo More articles by this author Yasuyoshi Miyata More articles by this author Hidenori Ito More articles by this author Hiroki Kurata More articles by this author Masahito Masato More articles by this author Kensuke Mitsunari More articles by this author Kojiro Ohba More articles by this author Hideki Sakai More articles by this author Expand All Advertisement PDF DownloadLoading ...