Multifactorial causes of irritating bladder symptoms in patients with sjögren's syndrome§

Authors

  • Kuang-Lun Lee,

    1. Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Chung Shiu Dong,

    1. Division of Urology, Department of Surgery, Far Eastern Memorial Hospital Ban- Ciao, Taipei, Taiwan and Graduate Institution of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
    2. Department of Urology, College of Medicine, National Taiwan University and Hospital, Taipei, Taiwan
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  • Mao-Yuan Chen,

    1. Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Chen-Hsun Ho,

    1. Department of Urology, College of Medicine, National Taiwan University and Hospital, Taipei, Taiwan
    2. Division of Urology, Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
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  • Huai-Ching Tai,

    1. Department of Urology, College of Medicine, National Taiwan University and Hospital, Taipei, Taiwan
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  • Shun-Fa Hung,

    1. Department of Urology, College of Medicine, National Taiwan University and Hospital, Taipei, Taiwan
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  • Hong-Jeng Yu

    Corresponding author
    1. Department of Urology, College of Medicine, National Taiwan University and Hospital, Taipei, Taiwan
    • Department of Urology, National Taiwan University Hospital, 7 South Chung-Shan Road, Taipei 100, Taiwan.
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  • Conflicts of interest: none.

  • Kuang-Lun Lee and Shiu-Dong Chung contributed equally to this work.

  • §

    Dirk De Ridder led the review process.

Abstract

Aims

Patients with Sjögren's syndrome (SS) are reported to have an increased severity of irritating bladder symptoms, including urinary frequency and urgency. The mechanism remains unclear. The aim of this study is to elucidate the possible etiologies underlying this problem.

Methods

Data from 23 female patients with SS (15 primary and 8 secondary) who were treated in the urology clinic for chronic, irritating bladder symptoms were studied.

Evaluation of each subject is composed of lower urinary tract symptoms (LUTS), bladder diary entries, and urodynamic studies, which also included an ice water test (IWT) to detect the presence of a C-fiber mediated micturition pathway. Interstitial cystitis (IC) was diagnosed with post-hydrodilatation cystoscopic findings of glomerulations and a KCl test.

Results

These patients complained predominantly of overactive bladder symptoms (OAB), including frequency (n = 20, 87%), nocturia (n = 16, 66%), and urgency (n = 12, 52%). Based on the aforementioned evaluations, four patients (17%) had polyuria with normal bladder function, nine patients (39%) had detrusor overactivity (DO), seven patients (32%) had bladder hypersensitivity (including two patients (9%) diagnosed with IC), and three patients (13%) had negative findings. Ice water instillation neither elicited novel involuntary contractions, both in those with or without DO. Five of the six patients (83%) with DO versus one of the four patients (25%) without DO responded to antimuscarinic therapy.

Conclusions

Various factors contribute to the irritating bladder symptoms in patients with SS, with DO being predominant. The LUTS developed in patients with SS are not due to any specific single etiology and that each patient must be individually carefully evaluated. Neurourol. Urodynam. 30:97–101, 2011. © 2010 Wiley-Liss, Inc.

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