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Li M, Xu M, Zhou H, Pan Y, Liu X. The association between different levels of depression and overactive bladder: A cross-sectional study of the 2005-2018 National Health and Nutrition Examination Survey. Neurourol Urodyn 2024. [PMID: 39032101 DOI: 10.1002/nau.25563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/05/2024] [Accepted: 07/10/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND There is growing evidence of a possible correlation between depression and overactive bladder (OAB). However, few studies have classified depression according to its severity. Whether there is an association between different levels of depression and OAB symptoms remains unclear. METHODS Participants with complete information about depression, OAB, and covariates in the National Health and Nutrition Examination Survey (NHANES) 2005-2018 were included in this study. Depression symptoms were assessed by the Patient Health Questionnaire-9. OAB symptoms were evaluated by the Overactive Bladder Symptom Score. Weighted multivariate logistic regression models were applied to analyze the relationship between depression and OAB. RESULTS A total of 30 359 participants were included in this study, consisting of 6245 OAB patients and 24 114 non-OAB participants. The multivariate logistic regression suggested depression independently correlated with OAB (odds ratio [OR] = 2.764, 95% confidence interval [CI] = 2.429-3.146, p < 0.001). Further, mild (OR = 2.355, 95% CI = 2.111-2.627, p < 0.001), moderate (OR = 3.262, 95% CI = 2.770-3.841, p < 0.001), and moderately severe to severe depression (OR = 3.927, 95% CI = 3.246-4.752, p < 0.001) were all associated with OAB. Additionally, depression was also correlated with urgency urinary incontinence (OR = 2.249, 95% CI = 1.986-2.548, p < 0.001) and nocturia (OR = 2.166, 95% CI = 1.919-2.446, p < 0.001). CONCLUSION This study indicated different levels of depression, even mild depression, were independent risk factors for OAB. Given the frequent coexistence and potential interactions between depression and OAB, clinicians should be aware of the importance of assessing both physical and psychological symptoms in these patients. Early diagnosis and holistic treatment may improve the treatment outcomes, particularly for those suffering from both conditions.
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Affiliation(s)
- Muwei Li
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mingming Xu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Hang Zhou
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yang Pan
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
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Zhang Y, Wu X, Liu G, Feng X, Jiang H, Zhang X. Association between overactive bladder and depression in American adults: A cross-sectional study from NHANES 2005-2018. J Affect Disord 2024; 356:545-553. [PMID: 38642902 DOI: 10.1016/j.jad.2024.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/12/2024] [Accepted: 04/08/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND AND AIM Overactive bladder (OAB) and depression are both common disorders and there is research suggesting an association between the two, but there is a lack of studies with large samples. The aim of this study is to investigate the association between OAB and depressive symptoms. METHODS We used data from the National Health and Nutrition Examination Survey (NHANES) database for the period 2005 to 2018. OAB was characterized by the Overactive Bladder Symptom Score (OABSS, score > 3) and depression was diagnosed by the Patient Health Questionnaire (PHQ-9, score ≥ 10). There were three models employed in our analysis: (1) Crude model was unadjusted; (2) Model 1 was adjusted for age, sex, race/ethnicity, educational level, and marital status; (3) Model 2 was adjusted for factors in Model 1 plus the remained potential covariates. We used survey-weighted logistic regression models to assess the association between OAB and depression. Subsequently, subgroup analyses and smoothed curve analyses were used to evaluate the reliability of the findings. RESULTS Finally, a total of 6612 participants were included in our study, consisting of 1005 participants with diagnosis of OAB and 5607 participants without diagnosis of OAB. After adjusting for all covariates, there was a significant positive association between OAB and depression (OR: 2.89, 95 % CI: 1.91, 4.37). The severity of OAB was also positively associated with depression. Compared to participants without OAB, the fully adjusted ORs for depression were 2.76 (95 % CI: 1.64, 4.65) for those with mild OAB, 3.79 (95 % CI: 1.68, 8.55) for those with moderate OAB, and 5.21 (95 % CI: 1.39, 19.53) for those with severe OAB. CONCLUSIONS This study revealed a strong association between OAB and depression and a progressive increase in the risk of depression as the severity of OAB (mild, moderate, and severe) increased. Therefore, it is important for clinicians to recognize the assessment of OAB symptoms in patients who are at risk for or have developed depressive symptoms, as well as the mental health of patients with OAB.
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Affiliation(s)
- Yuyang Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China
| | - Xu Wu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China
| | - Guodong Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China
| | - Xingliang Feng
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
| | - Hui Jiang
- Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center, Beijing, China.
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China.
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Shin YS, Soni KK, Lee DY, Kam SC. The relationship between depression, anxiety and lower urinary tract symptoms in men. Prostate Int 2024; 12:86-89. [PMID: 39036760 PMCID: PMC11255884 DOI: 10.1016/j.prnil.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/20/2024] [Accepted: 02/24/2024] [Indexed: 07/23/2024] Open
Abstract
Purpose Patients with lower urinary tract symptoms (LUTS) often experience comorbid depression and anxiety, yet the mechanisms underlying this association remain incompletely understood. This prospective study aimed to investigate the relationship between depression, anxiety, and LUTS in men. Materials and methods A prospective study was conducted with 350 male patients who underwent urologic examinations at our institution from January 2021 to December 2021. Of these, 131 patients meeting the inclusion criteria were included. Various questionnaires, including the International Prostate Symptom Score (IPSS) and the Hospital Anxiety and Depression Scale (HADS), as well as LUTS examinations (prostate-specific antigen test, transrectal ultrasonography, and urine flowmetry), were administered. Results Among the 350 patients, 131 were included in the analysis, with an average age of 58.0 ± 13.69 years. The total IPSS was 18.0 ± 8.69, with the average voiding symptom score at 8.7 ± 5.19 and the average storage symptom score at 6.0 ± 3.27. Both anxiety and depression were found to be correlated with LUTS (P < 0.05). After adjusting for age, hypertension, and diabetes, anxiety (but not depression) was significantly associated with LUTS based on regression analysis. Conclusion Men with LUTS are more likely to experience anxiety. Therefore, it is essential to assess and address anxiety when managing men with LUTS.
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Affiliation(s)
- Yu Seob Shin
- Department of Urology, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Kiran Kumar Soni
- Department of Physiology, Lord Buddha Koshi Medical College and Hospital, Saharsa, Bihar, India
| | - Dong Yun Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Sung Chul Kam
- Department of Urology, Gyeongsang National University Changwon Hospital, Institute of Health Sciences of Gyeongsang National University, Gyeongsang National University School of Medicine, Jinju, Korea
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Lin W, Wang H, Wu Z, Zhang W, Lin ME. Associations between exposure to organophosphate esters and overactive bladder in U.S. adults: a cross-sectional study. Front Public Health 2023; 11:1186848. [PMID: 38026372 PMCID: PMC10666646 DOI: 10.3389/fpubh.2023.1186848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background The relationship between exposure to organophosphate esters (OPEs) and the risk of developing overactive bladder (OAB) is uncertain. The purpose of this study is to examine the potential link between urinary metabolites of organophosphate esters and OAB. Method Data from the National Health and Nutrition Examination Survey (NHANES) database of the 2011-2016 cycles were utilized. Four urinary metabolites of organophosphate esters: diphenyl phosphate (DPHP), bis (1,3-dichloro-2-propyl) phosphate (BDCPP), bis (2-chloroethyl) phosphate (BCEP), and dibutyl phosphate (DBUP) were included in the study. Multivariate logistic regression and restricted cubic spline (RCS) were used to evaluate the relationship between urinary OPEs metabolites and OAB. Interaction analysis was conducted on subgroups to confirm the findings. Results A total of 3,443 United States (US) adults aged 20 years or older were included in the study, of whom 597 participants were considered to have OAB. After adjusting for potential confounding factors, we found a positive association between DPHP and the risk of overactive bladder. The risk of overactive bladder increased with increasing DPHP concentrations compared with quartile 1 (quartile 2, OR = 1.19, 95% CI, 0.82-1.73, P = 0.34; quartile 3, OR = 1.67, 95% CI, 1.10-2.53, P = 0.02; Q4, OR = 1.75, 95% CI, 1.26-2.43, P = 0.002). However, after dividing the participants by gender, only the female group retained consistent results. Additionally, restricted cubic spline analysis revealed a nonlinear dose-response correlation between DPHP and OAB in female participants. In the subgroup analysis based on age, race, body mass index (BMI), recreational activity, smoking status, drinking status, hypertension, diabetes, and stroke, the interaction analysis revealed that the findings were uniform. Conclusion Our findings indicate that exposure to DPHP could elevate the risk of OAB in US adult females. Further experimental studies are needed to explore the underlying mechanism in the future.
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Affiliation(s)
- Weilong Lin
- The First Affiliated Hospital of Shantou University Medical College, Medical College of Shantou University, Shantou, Guangdong, China
| | - Haoxu Wang
- The First Affiliated Hospital of Shantou University Medical College, Medical College of Shantou University, Shantou, Guangdong, China
| | - Zesong Wu
- Clinical Medicine Science, Shantou University Medical College, Shantou, Guangdong, China
| | - Wei Zhang
- The First Affiliated Hospital of Shantou University Medical College, Medical College of Shantou University, Shantou, Guangdong, China
- The First Affiliated Hospital of Shantou University Medical College Hao Jiang Hospital, Shantou, Guangdong, China
| | - Ming-En Lin
- The First Affiliated Hospital of Shantou University Medical College, Medical College of Shantou University, Shantou, Guangdong, China
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吉田 正. [Management for lower urinary tract dysfunction in the elderly according to guidelines]. Nihon Ronen Igakkai Zasshi 2022; 59:115-130. [PMID: 35650043 DOI: 10.3143/geriatrics.59.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chen YC, Liang YC, Ho SJ, Chen HW, Juan YS, Tsai WC, Huang SP, Lee JT, Liu YP, Kao CY, Lin YK, Long CY, Wu MN, Chen CJ, Wu WJ. Does COVID-19 Vaccination Cause Storage Lower Urinary Tract Symptoms? J Clin Med 2022; 11:jcm11102736. [PMID: 35628863 PMCID: PMC9148126 DOI: 10.3390/jcm11102736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 01/27/2023] Open
Abstract
We investigated the storage lower urinary tract symptoms (LUTS) before and after the first dose of coronavirus disease 2019 (COVID-19) vaccine and the association between pre-vaccinated overactive bladder (OAB) and the worsening of storage LUTS following COVID-19 vaccination. This cross-sectional study in a third-level hospital in Taiwan used the validated pre- and post-vaccinated Overactive Bladder Symptom Score (OABSS). Diagnosis of OAB was made using pre-vaccinated OABSS. The deterioration of storage LUTS was assessed as the increased score of OABSS following vaccination. Of 889 subjects, up to 13.4% experienced worsened storage LUTS after vaccination. OAB was significantly associated with an increased risk of worsening urinary urgency (p = 0.030), frequency (p = 0.027), and seeking medical assistance due to urinary adverse events (p < 0.001) after vaccination. The OAB group faced significantly greater changes in OABSS-urgency (p = 0.003), OABSS-frequency (p = 0.025), and total OABSS (p = 0.014) after vaccination compared to those observed in the non-OAB group. Multivariate regression revealed that pre-vaccinated OAB (p = 0.003) was a risk for the deterioration of storage LUTS. In conclusion, storage LUTS may deteriorate after vaccination. OAB was significantly associated with higher risk and greater changes in worsening storage LUTS. Storage LUTS should be closely monitored after COVID-19 vaccination, especially in those OAB patients.
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Affiliation(s)
- Yu-Chen Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yin-Chi Liang
- School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Shuo-Jung Ho
- School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Hao-Wei Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
| | - Yung-Shun Juan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Wei-Chung Tsai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan
- Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Shu-Pin Huang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Jung-Ting Lee
- Si Wan College, National Sun-Yat Sen University, Kaohsiung 80424, Taiwan
| | - Yu-Peng Liu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chung-Yao Kao
- Department of Electrical Engineering, National Sun-Yat Sen University, Kaohsiung 80424, Taiwan
| | - Yen-Ko Lin
- Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Medical Humanities and Education, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Cheng-Yu Long
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Meng-Ni Wu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chao-Ju Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Wen-Jeng Wu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Akbar A, Liu K, Michos ED, Bancks MP, Brubaker L, Markossian T, Durazo-Arvizu R, Kramer H. Association of Overactive Bladder With Hypertension and Blood Pressure Control: The Multi-Ethnic Study of Atherosclerosis (MESA). Am J Hypertens 2022; 35:22-30. [PMID: 33899909 DOI: 10.1093/ajh/hpaa186] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/20/2020] [Accepted: 04/06/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The sudden urge to urinate, also known as overactive bladder (OAB), may reflect higher sympathetic activity and associate with higher blood pressure (BP). METHODS This cross-sectional analysis utilized data from sixth follow-up exam (2015-2016) of Multi-Ethnic Study of Atherosclerosis to examine the association of OAB with systolic (SBP) and diastolic blood pressure (DBP) levels, hypertension, and BP control. Information on urinary symptoms was obtained with the International Consultation on Incontinence Questionnaire (ICIQ). Sex-stratified regression models were constructed to examine differences in BP, hypertension prevalence, and BP control while adjusting for demographic factors, comorbidities, and medication use. RESULTS Among the 1,446 men and 1,628 women who completed the ICIQ (mean age 73.7 years [SD 8.4]), OAB was present in 31.6% of men and 38.9% of women. With no antihypertensive medication use, OAB was not associated with SBP or DBP in both men and women after adjusting for covariates. However, among the 894 men and 981 women on antihypertensive medication, OAB was associated with higher SBP among men (4.04 mm Hg; 95% confidence interval [CI] 1.02, 7.06) but not among women (-0.67 mm Hg; 95% CI -3.79, 2.46) while DBP did not differ by OAB presence in men or women. In addition, OAB was also associated with lower odds of BP control among men (odds ratio [OR] 0.69; 95% CI 0.49, 0.96) but not women (OR 0.96; 95% CI 0.71, 1.30). CONCLUSIONS Among men, OAB is associated with lower odds of BP control which suggests that OAB may impede hypertension management.
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Affiliation(s)
- Aelia Akbar
- Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois, USA
| | - Kiang Liu
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael P Bancks
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Linda Brubaker
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, California, USA
| | - Talar Markossian
- Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois, USA
| | - Ramon Durazo-Arvizu
- Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois, USA
| | - Holly Kramer
- Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois, USA
- Department of Medicine, Loyola University Chicago, Maywood, Illinois, USA
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Phé V, Gamé X. [Definition, epidemiology and impact of non-neurogenic overactive bladder]. Prog Urol 2021; 30:866-872. [PMID: 33220814 DOI: 10.1016/j.purol.2020.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Overactive bladder (OAB) is a common condition with a significant functional impact in patients. OBJECTIVE To synthesize current knowledge on the definition, epidemiology and impact of OAB. METHOD A systematic literature review based on Pubmed, Embase, Google Scholar was conducted in June 2020. RESULTS OAB is defined by urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology. In France, OAB affects 14 % of the general population and this prevalence increases with age. This condition is a source of major deterioration in patients' quality of life with a physical (falls, fractures, sleep disorders, fatigue), psychic (anxiety, depression) social (limitation of leisure, isolation) and economic impact. CONCLUSION The definition of OAB is standardized. OAB is a frequent condition and has significant functional consequences with a notable deterioration in quality of life.
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Affiliation(s)
- V Phé
- Sorbonne université, service d'urologie, hôpital Pitié-Salpêtrière, assistance publique-hôpitaux de Paris, Paris, France.
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier, Toulouse, France
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Funada S, Luo Y, Yoshioka T, Setoh K, Tabara Y, Negoro H, Akamatsu S, Yoshimura K, Matsuda F, Furukawa TA, Efthimiou O, Ogawa O. Protocol for development and validation of a prediction model for 5-year risk of incident overactive bladder in the general population: the Nagahama study. BMC Urol 2021; 21:78. [PMID: 33985490 PMCID: PMC8120704 DOI: 10.1186/s12894-021-00848-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/09/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND An accurate prediction model could identify high-risk subjects of incident Overactive bladder (OAB) among the general population and enable early prevention which may save on the related medical costs. However, no efficient model has been developed for predicting incident OAB. In this study, we will develop a model for predicting the onset of OAB at 5-year in the general population setting. METHODS Data will be obtained from the Nagahama Cohort Project, a longitudinal, general population cohort study. The baseline characteristics were measured between Nov 28, 2008 and Nov 28, 2010, and follow-up was performed every 5 years. From the total of 9,764 participants (male: 3,208, female: 6,556) at baseline, we will exclude participants who could not attend the follow-up assessment and those who were defined as having OAB at baseline. The outcome will be incident OAB defined using the Overactive Bladder Symptom Score (OABSS) at follow-up assessment. Baseline questionnaires (demographic, health behavior, comorbidities and OABSS) and blood test data will be included as predictors. We will develop a logistic regression model utilizing shrinkage methods (LASSO penalization method). Model performance will be evaluated by discrimination and calibration. Net benefit will be evaluated by decision curve analysis. We will perform an internal validation and a temporal validation of the model. We will develop a web-based application to visualize the prediction model and facilitate its use in clinical practice. DISCUSSION This will be the first study to develop a model to predict the incidence of OAB.
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Affiliation(s)
- Satoshi Funada
- Department of Urology, Faculty of Medicine, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. .,Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan.
| | - Yan Luo
- Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | - Takashi Yoshioka
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima City, Fukushima, Japan.,Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and School of Public Health, Kyoto, Japan
| | - Kazuya Setoh
- Center for Genomic Medicine, Faculty of Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Faculty of Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Shusuke Akamatsu
- Department of Urology, Faculty of Medicine, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Koji Yoshimura
- Department of Urology, Shizuoka General Hospital, Shizuoka, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Faculty of Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | - Orestis Efthimiou
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Osamu Ogawa
- Department of Urology, Faculty of Medicine, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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Ito K, Inoue M, Nishii H, Matsumoto T. Prevalence of xerostomia with or without overactive bladder symptoms. Low Urin Tract Symptoms 2020; 13:224-229. [PMID: 33034141 DOI: 10.1111/luts.12354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/28/2020] [Accepted: 09/22/2020] [Indexed: 11/26/2022]
Abstract
Overactive bladder (OAB) occurs idiopathic or secondary to a neurological cause. In addition, OAB may also occur due to xerostomia, because it causes excessive drinking of water. If xerostomia is one of the causes of OAB, treating xerostomia may be effective. This study aimed to investigate the prevalence of xerostomia with or without overactive bladder symptoms. A web-based questionnaire was administered to investigate the prevalence of xerostomia with or without overactive bladder symptoms. The survey included questions concerning age, gender, medical history, medications, OAB symptoms by the Overactive Bladder Symptom Score (OABSS), and xerostomia by the Dry Mouth Scale (DMS). From the analysis, a total of 21 (13.0%) participants were identified as having OAB. The prevalence of xerostomia was six (28.6%) in the OAB group and 14 (10.0%) in the non-OAB group. OABSS and DMS were significantly higher in the OAB group than in the non-OAB group. Urgency score and urgency incontinence score of OABSS were substantially higher in xerostomia participants than non-xerostomia participants. The adjusted odds ratio of OAB showed DMS total score, xerostomia symptoms, accompanying symptoms, and other symptoms that were all significantly associated with OAB. These results suggested that OAB subjects, even untreated subjects, had xerostomia. It may be beneficial for clinicians to perform dry mouth management in parallel with careful choice pharmacotherapy for the wellness of OAB patients.
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Affiliation(s)
- Kayoko Ito
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Makoto Inoue
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan.,Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hisae Nishii
- Department of Urology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Tetsuro Matsumoto
- University of Occupational and Environmental Health, Kitakyushu, Japan
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Kawahara T, Ito H, Yao M, Uemura H. Impact of smoking habit on overactive bladder symptoms and incontinence in women. Int J Urol 2020; 27:1078-1086. [PMID: 32875688 PMCID: PMC7754378 DOI: 10.1111/iju.14357] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/20/2020] [Indexed: 12/04/2022]
Abstract
Objective To examine the correlation between smoking habit and lower urinary tract symptoms in women. Methods We first screened 10 000 female patients to examine their smoking habit. A total of 7004 samples were successfully collected for further analysis through a urinary continence survey. The ratio of current smoking to non‐smoking participants was set as 1:3 to allow thorough assessment of the impact of cigarette smoking on lower urinary tract symptoms. Results A total of 4756 complete responses were obtained for the Overactive Bladder Symptom Score and International Consultation on Incontinence Questionnaire‐Short Form questionnaire. The current smokers (2.54 ± 2.91, 2.48 ± 4.01) and ex‐smokers (2.27 ± 2.50, 2.25 ± 3.50) showed significantly higher Overactive Bladder Symptom Score and International Consultation on Incontinence Questionnaire‐Short Form scores than the non‐smokers (1.70 ± 2.05, 1.49 ± 2.73) (P < 0.0001, P < 0.0001 and P < 0.0001, P < 0.0001, respectively). The prevalence of urgency was affected by the smoking status. Younger participants (aged 20–39 years) showed a stronger influence of their smoking habit than older participants (aged ≥40 years). Urgency urinary incontinence was also affected by the smoking status. Conclusions The prevalence of urgency and urgency urinary incontinence is correlated with age and smoking habit, and both current and ex‐smokers show an increased prevalence of urgency and urgency urinary incontinence compared with non‐smokers, especially younger women.
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Affiliation(s)
- Takashi Kawahara
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan.,Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroki Ito
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan.,Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroji Uemura
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
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Wróbel A, Serefko A, Szopa A, Ulrich D, Poleszak E, Rechberger T. O-1602, an Agonist of Atypical Cannabinoid Receptors GPR55, Reverses the Symptoms of Depression and Detrusor Overactivity in Rats Subjected to Corticosterone Treatment. Front Pharmacol 2020; 11:1002. [PMID: 32733244 PMCID: PMC7360849 DOI: 10.3389/fphar.2020.01002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/22/2020] [Indexed: 11/21/2022] Open
Abstract
In view of the fact that GPR55 receptors are localized in brain areas implicated in the pathophysiology of depression, GPR55 gene expression is reduced in the dorsolateral prefrontal cortex of suicide victims, and GPR55 receptor agonism exerts an anxiolytic-like effect, GPR55 receptors have drawn our attention as a potential target in the treatment of mood disorders. Therefore, in the present study, we wanted to check whether a 7-day intravenous administration of O-1602 (0.25 mg/kg/day) – a phytocannabinoid-like analogue of cannabidiol that belongs to the agonists of GPR55 receptors, was able to reverse the corticosterone-induced depressive-like behavior accompanied by detrusor overactivity in female Wistar rats. Additionally, we tried to determine the influence of GPR55 stimulation on the bladder, hippocampal and urine levels of several biomarkers that play a role in the functioning of the urinary bladder and/or the pathophysiology of depression. Our experiments showed that O-1602 therapy improved signs of depression (measured by the forced swim test) and detrusor contractility (measured by conscious cystometry) in animals exposed to the corticosterone treatment. Moreover, the treatment reduced the oxidative damage in the urinary bladder and neuroinflammation (observed as the reduction of elevated levels of 3-NIT, MAL, and IL-1β, TNF-α, CRF, respectively). The O-1602 treatment also reversed the abnormal changes in the bladder, hippocampal or urine values of CGRP, OCT3, VAChT, BDNF, and NGF. The above-mentioned findings allow to suggest that in the future the modulation of atypical cannabinoid receptors GPR55 could have a potential role in the treatment of depression and overactive bladder.
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Affiliation(s)
- Andrzej Wróbel
- Second Department of Gynecology, Medical University of Lublin, Lublin, Poland
| | - Anna Serefko
- Laboratory of Preclinical Testing, Chair and Department of Applied and Social Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Aleksandra Szopa
- Laboratory of Preclinical Testing, Chair and Department of Applied and Social Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Daniela Ulrich
- Department of Obstetrics and Gynaecology, Medical University Graz, Graz, Germany
| | - Ewa Poleszak
- Laboratory of Preclinical Testing, Chair and Department of Applied and Social Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Tomasz Rechberger
- Second Department of Gynecology, Medical University of Lublin, Lublin, Poland
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Duloxetine reverses the symptoms of overactive bladder co-existing with depression via the central pathways. Pharmacol Biochem Behav 2020; 189:172842. [DOI: 10.1016/j.pbb.2019.172842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/04/2019] [Accepted: 12/28/2019] [Indexed: 12/20/2022]
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Abstract
Age and body mass index are associated with increased risks of overactive bladder, whereas employment status is associated with a decreased risk of overactive bladder. Objective The purpose of this study was to investigate the risk factors of overactive bladder (OAB). Methods The PubMed, Embase, and Cochrane Library databases were retrieved through May 2016. Odds ratios (OR) or standard mean differences (SMDs) with 95% confidence intervals (CIs) were used to evaluate the associations between risk factors and OAB. Heterogeneity among studies was examined using χ2 test based on the Q and I2 tests. Results A total of 28 articles were analyzed in our study. The results suggested that age and body mass index were significantly higher in OAB patients than in non-OAB controls (SMDs [95% CIs], 0.30 [0.19–0.41] and 0.39 [0.24–0.53]). A significant negative association was found between employment status and OAB (OR [95% CIs], 0.64 [0.46–0.90]). However, sex, educational level, parity, vaginal delivery, race, menopause, marital status, smoking, and alcohol consumption were not significantly different in OAB and non-OAB control patients (ORs [95% CIs], 0.95 [0.59–1.55], 1.04 [0.82, 1.33], 0.98 [0.56–1.70], 1.66 [0.90–3.07], 0.98 [0.75–1.28], 1.84 [0.23–14.70], 0.97 [0.78–1.19], 0.91 [0.77–1.08], and 0.88 [0.71–1.09], respectively). In addition, the number of parities and vaginal deliveries in OAB patients also showed no significant differences compared with non-OAB control patients (SMDs [95% CI], 0.05 [−0.27 to 0.38] and −0.16 [0.40 to 0.09]). Conclusions This meta-analysis suggests that age and body mass index are associated with increased risks of OAB, whereas employment status is associated with a decreased risk of OAB. Further prospective studies with large sample sizes are needed to confirm this conclusion.
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von Gontard A, Vrijens D, Selai C, Mosiello G, Panicker J, van Koeveringe G, Apostolidis A, Anding R. Are psychological comorbidities important in the aetiology of lower urinary tract dysfunction-ICI-RS 2018? Neurourol Urodyn 2019; 38 Suppl 5:S8-S17. [PMID: 31059602 DOI: 10.1002/nau.24016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/10/2019] [Accepted: 04/11/2019] [Indexed: 12/19/2022]
Abstract
AIMS To review studies on the comorbid psychological symptoms and disorders in patients with lower urinary tract disorders (LUTD) over the life-span, to analyse how they contribute toward the aetiology of LUTD and to discuss optimal service implementation. MATERIALS AND METHODS A review of relevant literature was conducted and presented during the ICI-RS meeting in 2018. Open questions and future directions were discussed. RESULTS On the basis of current research, there is overwhelming evidence in all age groups that psychological comorbidities are more common in patients with LUTD. Vice versa, patients with psychiatric disorders have higher rates of LUTD. The types of LUTDs and psychiatric disorders are heterogeneous. Complex aetiological models best explain specific associations of comorbidity. Irrespective of aetiology, it is advisable to address both urological and psychological issues in patients of all age groups with LUTD. CONCLUSIONS Psychological symptoms and disorders play a decisive role in the development of LUTD in all age groups and need to be considered in the assessment and treatment of LUTD.
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Affiliation(s)
- Alexander von Gontard
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany
| | - Desiree Vrijens
- Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Caroline Selai
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Giovanni Mosiello
- Department of Surgery, Urology and Neuro-Urology, Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Jalesh Panicker
- Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Gommert van Koeveringe
- Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Apostolos Apostolidis
- 2nd Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ralf Anding
- Department of Urology, Pediatric Urology and Neuro-Urology, University Hospital Bonn, Bonn, Germany
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Inhibition of Rho kinase by GSK 269962 reverses both corticosterone-induced detrusor overactivity and depression-like behaviour in rats. Eur J Pharmacol 2018; 837:127-136. [DOI: 10.1016/j.ejphar.2018.08.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/19/2018] [Accepted: 08/21/2018] [Indexed: 12/25/2022]
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Torimoto K, Matsumoto Y, Gotoh D, Morizawa Y, Miyake M, Samma S, Tanaka N, Hirayama A, Fujimoto K. Overactive bladder induces transient hypertension. BMC Res Notes 2018; 11:196. [PMID: 29580270 PMCID: PMC5870500 DOI: 10.1186/s13104-018-3317-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 03/21/2018] [Indexed: 11/10/2022] Open
Abstract
Objectives Several studies have shown the relationship between lower urinary tract symptoms and autonomic imbalance. We investigated the relationship between detrusor overactivity (DO) or urgency, and transient increase in blood pressure as a type of hypertension related to sympathetic hyperactivity. Study 1: we enrolled 14 male patients with DO and 10 without DO. We measured the overactive bladder symptom score (OABSS) and blood pressure during cystometry. Study 2: we enrolled 14 men patients with overactive bladder (OAB) and 8 without OAB. We measured OABSS and blood pressure using a 24-h ambulatory device. Results Study 1: the mean systolic pressure was significantly higher at urgency or SDV than at the other measurement points in the DO group (161.3 ± 23.2 vs. 134.5 ± 16.3, 137.8 ± 15.3, or 139.5 ± 14.8 mmHg). Study 2: the mean systolic pressure was significantly higher at the measurement points before micturition than at the points unrelated to micturition in the OAB group (159.7 ± 24.9 vs. 124.9 ± 13.8 mmHg). In conclusion, DO or urgency induces a transient increase of blood pressure, suggesting that OAB induces a type of hypertension before micturition.
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Affiliation(s)
- Kazumasa Torimoto
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
| | - Yoshihiro Matsumoto
- Department of Urology, Hoshigaoka Medical Center, 4-8-1 Hoshigaoka, Hirakata, Osaka, 573-8511, Japan
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Shoji Samma
- Department of Urology, Nara Prefecture General Medical Center, 1-30-1 Hiramatsu, Nara, Nara, 631-0846, Japan
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Akihide Hirayama
- Department of Urology, Kindai University Nara Hospital, 1248-1 Otoda-cho, Ikoma, Nara, 630-0227, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
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Tsui A, Kuh D, Cardozo L, Davis D. Vascular risk factors for male and female urgency urinary incontinence at age 68 years from a British birth cohort study. BJU Int 2018; 122:118-125. [PMID: 29512315 PMCID: PMC6221119 DOI: 10.1111/bju.14137] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objective To investigate the prevalence of urgency urinary incontinence (UUI) at age 68 years and the contribution of vascular risk factors to male and female UUI pathogenesis in addition to the associations with raised body mass index (BMI). Subjects and methods In all, 1 762 participants from the Medical Research Council (MRC) National Survey for Health and Development birth cohort who answered the International Consultation on Incontinence Questionnaire short form (ICIQ‐SF), at age 68 years, were included. Logistic regression was used to estimate associations between UUI and earlier life vascular risk factors including: lipid status, diabetes, hypertension, BMI, previous stroke or transient ischaemic attack (TIA) diagnosis; adjusting for smoking status, physical activity, co‐presentation of stress UI symptoms, educational attainment; and in women only, type of menopause, age at period cessation, and use of hormone replacement therapy (HRT). Results UUI was reported by 12% of men and 19% of women at age 68 years. Female sex, previous stroke or TIA diagnosis, increased BMI and hypertension (in men only) at age 60–64 years were independent risk factors for UUI. Female sex, increased BMI, and a previous diagnosis of stroke/TIA increased the relative risk of more severe UUI symptoms. Type and timing of menopause and HRT use did not alter the estimated associations between UUI and vascular risk factors in women. Conclusion Multifactorial mechanisms lead to UUI and vascular risk factors may contribute to the pathogenesis of bladder overactivity in addition to higher BMI. Severe UUI appears to be a distinct presentation with more specific contributory mechanisms than milder UUI.
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Affiliation(s)
- Alex Tsui
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Linda Cardozo
- Department of Urogynaecology, King's College Hospital, London, UK
| | - Daniel Davis
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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Jairam R, Drossaerts J, Vrijens D, Leue C, van Kerrebroeck P, van Koeveringe G. Affective symptoms and quality of life in patients with voiding or storage dysfunction: Results before and after sacral neuromodulation: A prospective follow-up study. Neurourol Urodyn 2018; 37:1801-1808. [DOI: 10.1002/nau.23527] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 01/17/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Ranjana Jairam
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
| | - Jamie Drossaerts
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
| | - Desiree Vrijens
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Carsten Leue
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
- Departmentof Psychiatry and Psychology, South Limburg Mental Health Research Teaching Network, EURON; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Philip van Kerrebroeck
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Gommert van Koeveringe
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
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Cross-Sectional Epidemiological Analysis of the Nagahama Study for Correlates of Overactive Bladder: Genetic and Environmental Considerations. J Urol 2018; 199:774-778. [DOI: 10.1016/j.juro.2017.09.146] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2017] [Indexed: 12/31/2022]
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Apostolidis A, Wagg A, Rahnam A'i MS, Panicker JN, Vrijens D, von Gontard A. Is there "brain OAB" and how can we recognize it? International Consultation on Incontinence-Research Society (ICI-RS) 2017. Neurourol Urodyn 2018; 37:S38-S45. [PMID: 29388707 DOI: 10.1002/nau.23506] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/26/2017] [Indexed: 02/06/2023]
Abstract
AIMS In light of mounting evidence supporting the association of brain regions with the control of urine storage and voiding, the high placebo effect in OAB studies as well as certain anecdotal observations from clinical practice with OAB patients, the role of the brain in OAB was explored. METHODS At the ICI-RS 2017 meeting, a panel of Functional Urologists and Basic Scientists presented literature data generating a proposal to discuss whether there is "brain OAB" and how we could recognize it. RESULTS Existing data point toward organic brain causes of OAB, in particular concerning white matter disease (WMD) and aging, but with currently speculative mechanisms. Imaging techniques have revealed connectivity changes between brain regions which may explain brain-peripheral interactions in OAB patients, further to acknowledged structural and functional changes in the central nervous system (CNS). Furthermore, psychological disorders like stress and depression have been identified as causes of OAB, with animal and human studies proposing a neurochemical and neuroendocrine pathophysiological basis, involving either the serotoninergic system or the hypothalamic-pituitary-adrenal axis. Finally, childhood data suggest that OAB could be a developmental disorder involving the CNS, although childhood OAB could be a different condition than that of adults in many children. CONCLUSIONS Future research should aim to identify the pathogenesis of WMD and the aging processes affecting the brain and the bladder, with possible benefits in prevention strategies, as well as connectivity disorders within the CNS, the pathophysiology of OAB in childhood and the neurochemical pathways connecting affective disorders with OAB.
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Affiliation(s)
- Apostolos Apostolidis
- 2nd Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Adrian Wagg
- Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Mohammad S Rahnam A'i
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jalesh N Panicker
- Department of Uro-Neurology, UCL Institute of Neurology, London, United Kingdom
| | - Desiree Vrijens
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Alexander von Gontard
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany
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Ferreira LR, Gameiro MO, Kawano PR, Yamamoto HA, Guerra R, Reis LO, Amaro JL. Schooling impacts on the overactive bladder diagnosis in women. Int Braz J Urol 2017; 43:1129-1135. [PMID: 28727389 PMCID: PMC5734077 DOI: 10.1590/s1677-5538.ibju.2016.0575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 04/22/2017] [Indexed: 11/21/2022] Open
Abstract
Objective: To evaluate the overactive bladder (OAB) diagnosis using OAB-V8 and ICIQOAB questionnaires in women with different schooling and cultural levels. Materials and Methods: Three hundred and eighty six healthy women answered a clinical questionnaire filling out information about schooling, demographic and gynecological data. The OAB-V8 and ICIQ-OAB questionnaires were used to evaluate OAB diagnosis and symptoms; and the QS-F questionnaire, to determine the sexual function. All questionnaires were validated in Portuguese. Results: The mean age was 37.3 years-old. Regarding to schooling level, 23.1% had concluded primary education; 65.8%, secondary school; and 11.1% had higher education. Considering the OAB-V8 (score ≥8), 51.8% of evaluated women had OAB diagnosis. There was a positive linear correlation between the OAB-V8 and ICIQ-OAB questionnaires in its sections “a” (r=0.812, p<0.001) and “b” (r=759, p<0.001). There was a positive linear correlation between age and the amount of time used to answer the OAB-V8, ICIQ-OAB and QS-F questionnaires (p<0.001). The ICIQ-OAB was the hardest to answer for all schooling levels when compared to the other questionnaires. Women who had concluded primary and secondary education significantly demanded more help to answer all questionnaires than those with higher education (p<0.05). Furthermore, women with higher education took significantly less time answering all questionnaires when compared to their less educated counterparts (primary and secondary schooling), since they were quicker to answer each individual question. Conclusion: Educational level and ageing had an impact on women response using different questionnaires for OAB and sexual function evaluations.
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Affiliation(s)
| | | | - Paulo R. Kawano
- Pontifícia Universidade Católica de Campinas - PUC Campinas, Brasil
| | | | - Rodrigo Guerra
- Pontifícia Universidade Católica de Campinas - PUC Campinas, Brasil
| | - Leonardo O. Reis
- Pontifícia Universidade Católica de Campinas - PUC Campinas, Brasil
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Kim SY, Bang W, Choi HG. Analysis of the prevalence of and factors associated with overactive bladder in adult Korean women. PLoS One 2017; 12:e0185592. [PMID: 28957446 PMCID: PMC5619804 DOI: 10.1371/journal.pone.0185592] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 09/17/2017] [Indexed: 01/27/2023] Open
Abstract
Background Overactive bladder (OAB) is one of the most prevalent lower urinary tract conditions and has been suggested to be related to various factors. We assessed the prevalence of and factors associated with OAB in women based on a large cross-sectional, population-based study of adult Korean women. Methods The Korean community health survey (KCHS) of 2012 was reviewed, and 107,950 female participants aged 19 to 107 years were identified for inclusion in this study. The overactive bladder symptom score (OABSS) was used to define and classify OAB as mild, moderate, or severe. Numerous variables, including marital status; physical activity; education and income levels; type of occupation; body mass index (BMI); smoking; alcohol; sleep time; and medical history of hypertension, diabetes mellitus, hyperlipidemia, or cerebral stroke, were evaluated. The correlation of these variables with the prevalence of OAB was analyzed using simple and multiple logistic regression analyses with complex sampling. Results The results showed that 5.2% of adult women experienced OAB. Multiple regression analyses showed a significant correlation between the following variables and OAB: older age (adjusted odds ratio [AOR] = 1.44, 95% confidence interval [CI] = 1.39–1.50, P < 0.001 as 10 years older); married status (AOR = 0.83, 95%CI = 0.70–0.96, P = 0.016); lower level of income (AOR = 1.50, 95%CI = 1.34–1.68, P < 0.001); high BMI (AOR = 1.33, 95%CI = 1.23–1.44, P < 0.001); smoking (AOR = 1.24, 95%CI = 1.04–1.47, P < 0.001); long sleep time (AOR = 1.95, 95%CI = 1.69–2.26); and medical history of hypertension (AOR = 1.11, 95%CI = 1.03–1.21, P = 0.011), diabetes mellitus (AOR = 1.38, 95%CI = 1.25–1.53, P < 0.001), hyperlipidemia (AOR = 1.27, 95%CI = 1.16–1.39, P < 0.001), and cerebral stroke (AOR = 2.04, 95%CI = 1.73–2.41, P < 0.001). The level of stress showed a dose-dependent association with OAB (AOR [95%CI] = 3.28 [2.81–3.83] > 2.11 [1.91–2.33] >1.28 [1.16–1.41] for severe > moderate > some stress, respectively, P < 0.001). Conclusion The prevalence of OAB was approximately 5.2% among adult Korean women. Older age; high BMI; stress level; sleep duration; levels of income and education; marital status; smoking; and medical history of hypertension, diabetes mellitus, hyperlipidemia, and cerebral stroke were significantly related to OAB in women.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Woojin Bang
- Department of Urology, Hallym University College of Medicine, Seoul, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Seoul, Korea
- * E-mail:
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Is There Any Difference Between Depression and Anxiety in Overactive Bladder According to Sex? A Systematic Review and Meta-Analysis. Int Neurourol J 2017; 21:204-211. [PMID: 28954462 PMCID: PMC5636958 DOI: 10.5213/inj.1734890.445] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/13/2017] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Overactive bladder (OAB) is characterized by urinary urgency with or without urge incontinence, accompanied by frequency and nocturia. It affects individuals of all ages and can predispose affected individuals to depression and anxiety. However, few studies have been conducted on this topic. The objective of this study was to perform a systematic review and meta-analysis assessing the symptoms of depression, anxiety, and OAB using validated instruments. METHODS The search for articles was based on the following descriptors: overactive bladder, depression, and anxiety ("Urinary bladder, Overactive AND Depression and Anxiety") OR ("Urinary bladder, Overactive AND Depression" OR "Urinary bladder, Overactive AND Anxiety"). The databases searched included PubMed, MEDLINE, and SciELO. RESULTS Initially, 111 articles were identified, but only 11 articles, containing 11,784 participants with depression and 10,436 with anxiety, specifically addressed depression or anxiety and were included in this systematic review. Ten articles incorporated a quantitative analysis, with cohort, series, population-based, and cross-sectional designs. One qualitative study was also included. Three articles were included in the meta-analysis, resulting in a total of 7,468 participants in whom depression was evaluated and 8,030 participants in whom anxiety was analyzed. Depression and anxiety were positively correlated with OAB. Men with OAB were considerably more likely than women to have anxiety (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.40-1.73) but there was no sex-related difference in depression (OR, 0.96; 95% CI, 0.77-1.21). CONCLUSIONS This study showed a positive correlation between OAB and anxiety and depression. Men were considerably more likely than women to have anxiety related to OAB, but depression levels in OAB patients were not sex-related. This review highlights the need to investigate depression and anxiety in patients with OAB.
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Huang CLC, Wu MP, Ho CH, Wang JJ. The bidirectional relationship between anxiety, depression, and lower urinary track symptoms: A nationwide population-based cohort study. J Psychosom Res 2017; 100:77-82. [PMID: 28789796 DOI: 10.1016/j.jpsychores.2017.07.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 07/15/2017] [Accepted: 07/16/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evidence has shown a positive correlation between lower urinary tract symptoms (LUTS) and anxiety/depression, but the direction and strength of the association are still unclear. We aimed to test the bidirectional association between LUTS and anxiety/depression using a longitudinal population database. METHODS Using claims data obtained from the Taiwan National Health Insurance Research Database, 17,489 patients with LUTS and 34,978 non-LUTS matched controls (cohort 1); and 45,707 patients with anxiety, 19,306 patients with depression, 91,414 non-anxiety, and 38,720 non-depression matched controls (cohort 2) were enrolled between 1999 and 2008. All subjects were followed at least three years or until the date of death or the end of 2011 to estimate the risk of developing anxiety/depression (cohort 1) or LUTS (cohort 2). RESULTS After controlling for age, gender, and medical comorbidities, LUTS patients were 2.12 (95%CI: 1.95-2.30) and 2.03 (95%CI: 1.76-2.33) times more likely to develop anxiety and depression, respectively. After controlling for age, gender, and medical comorbidities, patients with anxiety and depression were 2.01 (95%CI: 1.88-2.14) and 2.37 (95%CI: 2.13-2.65) times more likely to develop LUTS, respectively. LIMITATIONS The incidence of anxiety, depression, and LUTS may be under-estimated because only healthcare-seeking subjects were enrolled in our study. CONCLUSIONS Our findings suggested a bidirectional relationship between administrated anxiety/depression and LUTS in the cohorts. Further studies are warranted to clarify the underlying mechanisms.
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Affiliation(s)
- Charles Lung-Cheng Huang
- Department of Psychiatry, Chi Mei Hospital, Tainan, Taiwan; Department of Social Work, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
| | - Ming-Ping Wu
- Division of Urogynecology and Pelvic Floor Reconstruction, Department of Obstetrics and Gynecology, Chi Mei Hospital, Tainan, Taiwan; Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Hospital, Tainan, Taiwan; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Hospital, Tainan, Taiwan.
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Bontempo APDS, Alves AT, Martins GDS, Jácomo RH, Malschik DC, Menezes RLD. Factors associated with overactive bladder syndrome in the elderly community: a cross-sectional study. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2017. [DOI: 10.1590/1981-22562017020.170030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: to identify risk factors related to overactive bladder syndrome. Method: a cross-sectional study was performed with elderly women (>60 years) from the community of Ceilândia, in the Distrito Federal, Brazil, with or without symptoms of OBS, who were evaluated through interviews and questionnaires. The clinical and sociodemographic variables analyzed were: age; body mass index (BMI); parity, schooling, previous abdominal and urogynecologic surgeries, physical activity, smoking, constipation, systemic arterial hypertension (SAH), diabetes mellitus; depression and anxiety. The questionnaires applied were the Overactive Bladder Awareness Tool (OAB-V8), the Geriatric Depression Scale and the Beck Anxiety Scale. Data were analyzed descriptively. Binary logistic regression was used to evaluate the significant associations between the independent variables and the outcome of interest. Risk ratios were calculated for each independent variable with 95% confidence intervals. Result: A total of 372 volunteers were recruited, 292 of whom were eligible. Of these, 172 were allocated to the case group (58.9%) and 120 (41.1%) were control subjects. The two groups were homogeneous between one another. There was a high prevalence of OBS in the study population and significant differences for the variables presence of SAH, abdominal surgery and pelvic surgery, with the case group presenting a higher frequency of these events. In multivariate analysis, it was observed that an active sexual life reduces the chance of having OBS by 70.8%, while urogynecologic surgeries increase this risk 3.098 times. Conclusion: In univariate logistic regression analysis, BMI, SAH, a previous history of abdominal and urogynecologic surgery, number of abortions and the presence of symptoms of depression and anxiety, were found to be factors associated with OBS.
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The influence of duloxetine on detrusor overactivity in rats with depression induced by 13-cis-retinoic acid. Int Urogynecol J 2017; 29:987-995. [PMID: 28762178 PMCID: PMC6004276 DOI: 10.1007/s00192-017-3424-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/30/2017] [Indexed: 11/03/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of this study was to assess the efficacy of duloxetine in an animal model of detrusor overactivity induced by depression. METHODS After 6 weeks of 13-cis-retinoic acid administration at a dose of 1 mg/kg/day, rats were given duloxetine at a dose of 1 mg/kg. This was followed by conscious cystometry, a forced swim test, and locomotor activity measurement. The levels of corticotropin-releasing factor (CRF) in the hypothalamus, amygdala and plasma were also determined. RESULTS Duloxetine treatment led to a reduction in detrusor overactivity symptoms induced by the retinoid. Decreases were observed in cystometric parameters including the detrusor overactivity index, and the amplitude and frequency of nonvoiding contractions, while increases were seen in bladder compliance and the volume threshold to elicit nonvoiding contractions. No statistically significant differences were found in basal pressure, threshold pressure, micturition voiding pressure, postvoid residual , volume threshold, voiding efficiency, intercontraction interval, bladder contraction duration or relaxation time. Duloxetine also reduced the immobility time to that observed in control animals, while it did not affect locomotor activity. Its effects also included lowering of the CRF levels in the hypothalamus, amygdala and plasma, which increased following the prior administration of the retinoid. The plasma level of 13-cis-retinoic acid in rats corresponded to the levels found in humans. CONCLUSIONS This is the first study showing the efficacy of duloxetine in an animal model of detrusor overactivity induced by depression. Further studies in patients with detrusor overactivity and coexisting depression are warranted to confirm these experimental results.
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Kim SY, Bang W, Choi HG. Analysis of the prevalence and associated factors of overactive bladder in adult Korean men. PLoS One 2017; 12:e0175641. [PMID: 28407021 PMCID: PMC5391112 DOI: 10.1371/journal.pone.0175641] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/29/2017] [Indexed: 11/18/2022] Open
Abstract
Overactive bladder (OAB) is a prevalent condition characterized by lower urinary tract symptoms (LUTS). Age, education, income, marital status, sleep, and emotional problems have been associated with OAB; however, conflicting results exist. The present study was conducted to estimate the prevalence of OAB and comprehensively analyze its associated factors in a large cross-sectional, population-based study. The data of 94,554 participants aged 19-107 were analyzed from the Korean Community Health Survey (KCHS) of 2012. Data on marital status, physical activity, education level, occupation, body mass index (BMI), income level, sleep time, and stress level were retrieved for all enrolled participants. The overactive bladder symptom score (OABSS) was used to evaluate the presence and degree of OAB. Simple and multiple logistic regression analyses with complex sampling were used for the associations between various factors and the presence of OAB. Overall, OAB was present in approximately 2.9% of the participants. The prevalence of OAB increased with age and steeply increased after 60 years of age (adjusted odds ratio [AOR] for each 10 years = 1.70, 95% confidence interval [CI] = 1.61-1.80, P<0.001). The prevalence of OAB was lower in married than unmarried subjects (AOR = 0.59, 95% CI = 0.48-0.72, P<0.001). The prevalence of OAB was significantly different according to occupation Compared to manager, expert, specialist, clerk group, the prevalence of OAB was highest in unemployed group (AOR = 1.90, 95% CI = 1.55-2.32, P < 0.001). Being underweight was correlated with OAB (AOR = 1.29, 95% CI = 1.08-1.55, P = 0.018). Inadequate sleep showed a significant association with OAB (AOR = 1.13, 95% CI = 1.02-1.25 for ≤6 hours of sleep time and AOR = 1.53, 95% CI = 1.27-1.86 for ≥9 hours of sleep, P<0.001). Stress level showed a dose-dependent positive association with OAB [AOR (95% CI) = 3.91 (3.13-4.89) > 2.16 (1.88-2.48) > 1.39 (1.23-1.57) for severe stress > moderate stress > some stress, respectively, P<0.001]. A medical history of diabetes mellitus, hyperlipidemia, and/or cerebral stroke was significantly related to OAB. Approximately 2.9% of adult Korean men experienced OAB based on the OABSS. Unmarried status; occupation; being underweight; inadequate sleep; stress; and medical history of diabetes mellitus, hyperlipidemia, or cerebral stroke were significantly correlated with OAB.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Woojin Bang
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
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Melotti IGR, Juliato CRT, Tanaka M, Riccetto CLZ. Severe depression and anxiety in women with overactive bladder. Neurourol Urodyn 2017; 37:223-228. [PMID: 28407347 DOI: 10.1002/nau.23277] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 01/04/2017] [Indexed: 11/05/2022]
Abstract
AIM Depression and anxiety are prevalent psychiatric conditions and are associated with overactive bladder. The objective of this study was to determine prevalence and severity of anxiety and depression associated with overactive bladder (OAB) in women. METHODS 274 women with clinical diagnosis of OAB were recruited from 2012 to 2015. They were submitted to the International Consultation on Incontinence Questionnaire-Overactive Bladder (ICIQ-OAB), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). RESULTS Severe or moderate depression was present in 59.8% of women and severe or moderate anxiety was identified in 62.4%. Higher scores of depression and anxiety were associated with higher scores of ICIQ-OAB (P = 0.0031 and 0.0049). Women with severe depression had higher nocturia score than those with mild depression (P = 0.0046). Also, women with severe depression had higher urgency incontinence score than those with minimal depression (P = 0.0261). Patients with severe anxiety had higher nocturia score than those with minimal anxiety (P = 0.0118) and women with moderate anxiety had higher urgency incontinence score than with minimal anxiety (P = 0.0300). CONCLUSIONS Moderate or severe depression and anxiety are prevalent in women with OAB. There is a correlation between intensity of OAB symptoms with depression and anxiety. Anxiety and depression levels are mainly related with urgency incontinence and nocturia.
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Affiliation(s)
| | - Cássia Raquel Teatin Juliato
- Departament of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | - Mariana Tanaka
- Departament of Surgery, School of Medicine, University of Campinas (UNICAMP) - School of Medicine, Campinas, Brazil
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Lai HH, Shen B, Rawal A, Vetter J. The relationship between depression and overactive bladder/urinary incontinence symptoms in the clinical OAB population. BMC Urol 2016; 16:60. [PMID: 27716241 PMCID: PMC5053341 DOI: 10.1186/s12894-016-0179-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/23/2016] [Indexed: 11/23/2022] Open
Abstract
Background To investigate the relationship between depression and overactive bladder (OAB)/urinary incontinence symptoms among the clinical OAB population. Methods Patients who were diagnosed with overactive bladder (OAB) and age-matched control subjects without OAB were enrolled. Depression symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS-D). OAB/incontinence symptoms were assessed using the validated questionnaires: ICIQ-UI, ICIQ-OAB, UDI-6, IIQ-7, and OAB-q. Results 27.5 % of OAB patients in our study had depression (HADS ≥8), and 12 % of OAB patients had moderate to severe depression (HADS-D ≥11). OAB patients reported significantly higher HADS-D depression scores compared to age-matched controls (5.3 ± 3.9 versus 2.8 ± 3.9, p = 0.004). OAB patients with depression reported more severe incontinence symptoms (ICIQ-UI), greater bother and more impact on quality of life (UDI-6, IIQ-7) compared to OAB patients without depression (p = 0.001, 0.01, <0.001, respectively). However there were no differences in ICIQ-OAB and OAB-q. Among OAB patients, there were positive correlations between the severity of depression symptoms and OAB/incontinence symptoms (p-values <0.001 to 0.035). Conclusions 27.5 % of OAB patients have depression. OAB patients with depression reported more severe urinary incontinence symptoms, greater bother and more impact on quality of life compared to those without depression. Future studies are needed to further examine the mechanistic links between depression and OAB/urinary incontinence.
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Affiliation(s)
- H Henry Lai
- Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO, 63110, USA. .,Department of Anesthesiology, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO, 63110, USA.
| | - Baixin Shen
- Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO, 63110, USA
| | - Amar Rawal
- Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO, 63110, USA
| | - Joel Vetter
- Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St Louis, MO, 63110, USA
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Fourteen-day administration of corticosterone may induce detrusor overactivity symptoms. Int Urogynecol J 2016; 27:1713-1721. [PMID: 27142032 PMCID: PMC5065892 DOI: 10.1007/s00192-016-3027-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 04/11/2016] [Indexed: 12/19/2022]
Abstract
Introduction and hypothesis Epidemiological studies demonstrated that patients suffering from overactive bladder often present with different mental problems, amongst which depression is the most frequently observed. The main goal of our study was to check if the repeated administration of corticosterone (CORT) is able to evoke the depressive-like behaviour and detrusor overactivity (DO) symptoms in rats. Moreover, we investigated whether the acute administration of common antidepressants (imipramine, 30 mg/kg, and fluoxetine, 15 mg/kg), antimuscarinic (oxybutynin chloride, 0.5 mg/kg) or CRF1 (SN 003, 1 mg/kg) antagonists has an impact on the cystometric parameters, behaviour in the Porsolt test, and overall locomotor activity of animals exposed to CORT. Methods The experiments were carried out on female Wistar rats. All applied surgical and histopathology procedures, cystometric investigations, locomotor activity and forced swim measurements have been fully described in the published literature. Results Fourteen-day administration of CORT may induce both depressive and DO symptoms in rats, which are reversed by the inhibition of CRF1 receptors. Conclusions It seems that the CRF1 receptor could be an interesting target for overactive bladder pharmacotherapy, particularly in patients with co-existing depression.
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Wróbel A, Rechberger T. An animal model of detrusor overactivity induced by depression. J Pharmacol Toxicol Methods 2016; 80:19-25. [PMID: 27050558 DOI: 10.1016/j.vascn.2016.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/18/2016] [Accepted: 04/01/2016] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Depression is frequently found in patients suffering from overactive bladder. The aim of the study was to verify whether the 13-cis-retinoic acid, a synthetic retinoid used in the treatment of acne, which was proven to induce depressive changes in both humans and animals, can cause detrusor overactivity symptoms in conscious rats. METHODS In order to assess the 13-cis-retinoic acid impact on the behavioural parameters, after 6weeks of intraperitoneal administration of retinoid in a dose of 1mg/kg/day, a forced swim test and cystometry were performed, and the locomotor activity of animals was assessed. The control group received a mixture of DMSO and physiological saline at a 1:1 ratio. RESULTS 13-cis-retinoic acid caused cystometric parameter changes analogous to those observed in people with a urodynamic diagnosis of detrusor overactivity. The retinoid caused also an extension of the immobility time in the forced swim test which is consistent with increased depression-related behaviour, with no impact on the locomotor activity of rats. The intravenous administration of solifenacin succinate in a single dose of 0.03mg/kg turned out to reverse changes in the cystometric parameters modified by 13-cis-retinoic acid treatment. The histopathological analysis of bladders did not show any lesions in the upper layer of the umbrella cells, urothelium or muscles. The retinoid concentration level achieved in the animals tested turned out to be identical to that occurring in humans. DISCUSSION 13-cis-retinoic acid can induce detrusor overactivity symptoms that are reversed by solifenacin succinate.
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Affiliation(s)
- Andrzej Wróbel
- Second Department of Gynecology, Medical University of Lublin, Jaczewskiego 8, PL 20-090 Lublin, Poland.
| | - Tomasz Rechberger
- Second Department of Gynecology, Medical University of Lublin, Jaczewskiego 8, PL 20-090 Lublin, Poland
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Matsukawa Y, Takai S, Asai K, Kasugai S, Narita H, Komatsu T, Kashiwagi Y, Kato M, Yamamoto T, Gotoh M. A Slow Stream Is Pathophysiologically Related to a Poor Response to α1-Adrenoceptor Therapy in the Treatment of Storage Symptoms Associated With Benign Prostatic Hyperplasia. Urology 2015; 86:558-64. [DOI: 10.1016/j.urology.2015.03.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 03/26/2015] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
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Vrijens D, Drossaerts J, van Koeveringe G, Van Kerrebroeck P, van Os J, Leue C. Affective symptoms and the overactive bladder - a systematic review. J Psychosom Res 2015; 78:95-108. [PMID: 25499886 DOI: 10.1016/j.jpsychores.2014.11.019] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 11/17/2014] [Accepted: 11/20/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Overactive bladder syndrome (OAB) is characterised by urgency symptoms, with or without urgency incontinence, usually with frequency and nocturia. Although literature suggest an association between OAB, depression and anxiety, no systematic review has been presented. OBJECTIVE Systematically review the literature on the association of affective conditions with OAB. METHODS Systematic review according to the PRISMA guidelines. This review is registered in the PROSPERO register (CRD4201400664). RESULTS Forty-three articles were included, describing more than 80,000 subjects. Depression and OAB were positively associated in 26 studies, anxiety and OAB in 6 studies. Longitudinal studies reported: a) OAB subjects who developed depression/anxiety or b) depressed/anxious subjects developing OAB, or c) both. The quality of evidence in studies reporting an association between the co-occurrence of OAB and depression was rated level 3 in accordance with the GRADE framework. Evidence reporting on the co-occurrence of anxiety and OAB was rated GRADE level 2. Longitudinal associations between new onset of OAB in depressive subjects was GRADE level 2. Evidence reporting association of OAB with anxiety in longitudinal studies was of GRADE level 1. CONCLUSION To our knowledge, this systematic review is the first to give a comprehensive qualitative overview on the association between OAB and affective symptoms. Many evaluated studies failed to note longitudinal changes and lacked evidence of causality. Still, results revealed an association between OAB and affective symptoms and there is evidence for new onset of OAB in depressive subjects, but further research is necessary to examine the strength of the effect.
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Affiliation(s)
- Desiree Vrijens
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands; Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Jamie Drossaerts
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Gommert van Koeveringe
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands; Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Philip Van Kerrebroeck
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands; Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Jim van Os
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands; King's College London, King's Health Partners, London, Institute of Psychiatry, United Kingdom.
| | - Carsten Leue
- Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands.
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Abstract
The International Continence Society (ICS) defines overactive bladder (OAB) as an association of symptoms including "urgency, with or without urge incontinence, usually with increased frequency and nocturia". This conditon has been associated with a decrease in quality of life and a higher related risk of overall health condition decrease, and is rising since its prevalence increases with age and the forecast for the world population estimates an increase of those over 65 years old. Aging alone can be considered a major risk factor for developing OAB symptoms that are considered multifactorial and due to body tissue and anatomic changes, lifestyle-associated factors, comorbidities and personal characteristics. The high prevalence of this condition and multiple etiology factors makes of its treatment a challenge-especially in the older population. A major concern over OAB treatment of elderly patients is the risk of cognitive side effects due to the pharmacologic treatment with anticholinergic drugs. First-line treatment for OAB symptoms are the use of pharmacologic therapy with antimuscarinic drugs, which has been proved to be effective in controlling urgency, urge incontinence episodes, incontinence episodes, and nocturia. The impact caused by this condition is significant regarding the economic and human costs associated bringing into attention the need of studying and reviewing this specific population. Conservative Management and Lifestyle Modifications: Behavioral therapy's aims are to reduce urinary frequency and urgency to an accepted level and to increase bladder outlet volume. It consists of actions to teach patients to improve and learn bladder control. Lifestyle modifications are a conjunct of daily activities that can be managed to have the lowest interference on the functioning of the urinary tract. Pharmacologic Therapy: There are various medications with antimuscarinic properties available for the treatment of OAB symptoms. The most commonly used are oxybutinin, tolterodine, solifenacin, darifenacin, fesosterodine and trospium. Second-line Therapy: OAB treatment accounts for some refractory to conventional treatment patients who will require alternative therapies to achieve improvement of symptoms as the use of intradetrusor injection of botulinum A toxin by binding to receptors on the membrane of cholinergic nerves causing temporary chemodenervation and consequent muscle relaxation. Neuromodulation is also an effective therapy that aims to achieve inhibition of detrusor activity by continuous neural stimulation through peripheral nerves as the use of the tibial nerve or central as it is performed by direct spine stimulation on sacral roots through the implantation of an automated generator. In conclusion, evidence from the literature has shown that antimuscarinic treatment of OAB in the elderly population is safe and effective in improving symptoms and patient's quality of life. Managing OAB symptoms in this population is a great challenge. An optimal therapeutic approach to treat should involve medical treatment with drug and behavioral therapy in addition to lifestyle advice.
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Affiliation(s)
- Ricardo Natalin
- Department of Geriatric Urology, Federal University of Sao Paulo, Rua Napoleão de Barros, 715, 2 andar, São Paulo, Brazil
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SAKAKIBARA R, ITO T, YAMAMOTO T, UCHIYAMA T, YAMANISHI T, KISHI M, TSUYUSAKI Y, TATENO F, KATSURAGAWA S, KUROKI N. Depression, Anxiety and the Bladder. Low Urin Tract Symptoms 2013; 5:109-20. [DOI: 10.1111/luts.12018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Revised: 02/20/2013] [Accepted: 02/20/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Ryuji SAKAKIBARA
- Division of Neurology, Department of Internal Medicine, Sakura Medical Center; Toho University; Sakura Japan
| | - Takashi ITO
- Division of Neurology; Chiba University; Chiba Japan
| | | | | | | | - Masahiko KISHI
- Division of Neurology, Department of Internal Medicine, Sakura Medical Center; Toho University; Sakura Japan
| | - Yohei TSUYUSAKI
- Division of Neurology, Department of Internal Medicine, Sakura Medical Center; Toho University; Sakura Japan
| | - Fuyuki TATENO
- Division of Neurology, Department of Internal Medicine, Sakura Medical Center; Toho University; Sakura Japan
| | | | - Nobuo KUROKI
- Mental Health Clinic, Sakura Medical Center; Toho University; Sakura Japan
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