Painful bladder symptoms related to somatic syndromes in a convenience sample of community women with overactive bladder symptoms

Herein we aim to investigate the relationship between painful bladder filling and urinary urgency with somatic and chronic pain symptoms in women with overactive bladder (OAB) without an interstitial cystitis/bladder pain syndrome (IC/BPS) diagnosis.

Women meeting OAB criteria based on symptoms were recruited through the community (n=183, 83.9%) or Urology clinic (n=35, 16.1%) to complete validated questionnaires assessing urinary symptoms, somatic symptoms, and pain syndromes. Participants were categorized into 3 groups, (1) Neither (2) Either or (3) Both, based on their report of painful urinary urgency and/or painful bladder filling. Multivariable regression analyses were performed to determine factors predictive of having either or both painful urgency and/or painful filling.

Of 218 women with OAB, 46% (n=101) had neither painful bladder filling nor urinary urgency, 43% (n=94) had either, and 11% (n=23) had both. Controlling for age, women with either or both urologic pain symptoms were more likely to have irritable bowel syndrome, chronic pelvic pain, and temporomandibular disorder compared to women in the neither group. Additionally, these women had higher pain intensity and somatic symptoms scores than women with neither symptom.

The majority of women with OAB, without a diagnosis of IC/BPS, reported either painful urgency, painful filling, or both. Experiencing painful urgency and/or filling was associated with increased somatic symptom burden and pain intensity. These findings support the hypothesis that OAB and IC/BPS diagnoses may represent a continuum of bladder hypersensitivity.

The Journal of urology. 2018 Jul 11 [Epub ahead of print]

Casey G Kowalik, Joshua A Cohn, Sophia Delpe, Melissa R Kaufman, Alan Wein, Roger R Dmochowski, W Stuart Reynolds

Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: ., Department of Urology, Einstein Healthcare Network, Philadelphia, Pennsylvania., Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.