Somatic syndromes and chronic pain in women with overactive bladder

Mechanisms underlying pain perception and afferent hypersensitivity, such as central sensitization, may impact overactive bladder (OAB) symptoms. However, little is known about associations between OAB symptom severity, pain experience, and presence of comorbid chronic pain syndromes. This study examined relationships between OAB symptoms, somatic symptoms, and specific chronic pain conditions in which central sensitization is believed to play a primary role, in a community-based sample of adult women with OAB.

We recruited adult women with OAB to complete questionnaires assessing urinary symptoms, pain and somatic symptoms, and preexisting diagnoses of central sensitivity syndromes. We analyzed the effects of overall bodily pain intensity, general somatic symptoms, and diagnoses of central sensitivity syndromes on OAB symptom bother and health-related quality of life.

Of the 116 women in this study, over half (54%) stated their urge to urinate was associated with pain, pressure, or discomfort. Participants reported a wide range of OAB symptoms and health-related quality of life. There was a significant, positive correlation between OAB symptoms and somatic symptoms as well as overall pain intensity. Only 7% of women met diagnostic criteria for fibromyalgia; yet these women demonstrated significantly increased OAB symptom burden and decreased OAB quality of life compared to those without fibromyalgia.

Women with more severe OAB symptoms reported increased general somatic symptom burden and increased overall body pain intensity, especially women with fibromyalgia. These findings suggest that attributes of pain and co-morbidity with chronic pain conditions may impact the experience of OAB symptoms for many women. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc.

Neurourology and urodynamics. 2016 Jul 01 [Epub ahead of print]

W Stuart Reynolds, Stephen Mock, Xuechao Zhang, Melissa Kaufman, Alan Wein, Stephen Bruehl, Roger Dmochowski

Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Division of Urology, Penn Medicine, Philadelphia, Pennsylvania., Department of Anesthesia, Vanderbilt University Medical Center, Nashville, Tennessee., Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.