Associations between individual lower urinary tract symptoms and bacteriuria in random urine samples in women

Authors


  • Christopher Chapple led the peer-review process as the Associate Editor responsible for the paper.
  • Conflict of interest: Vik Khullar is a speaker, consultant, and paid investigator for Astellas Pharma, Allergan, and Pfizer. G. Alessandro Digesu is a speaker, consultant, and paid investigator for Astellas Pharma, AMS, Uroplasty, Medtronic, Pfizer.

Abstract

Aims

Previous studies have noted an association between a diagnosis of overactive bladder and bacteriuria, but little is understood about the relationship of bacteriuria to specific LUTS. We hypothesized that bacteriuria in women would be associated with increased self-reported symptom scores for a wide range of LUTS.

Methods

Women were recruited from general gynecology and urogynecology outpatient clinics in a secondary care setting. Women completed the 12-item International Consultation on Incontinence Questionnaire for Female Lower Urinary Tract Symptoms and provided a clean-catch mid-stream specimen of urine for microscopy and culture. Women with acute urinary tract infection were excluded. Three statistical approaches (Mann–Whitney U-test, multivariable logistic regression, and receiver operating characteristic curves) were used to assess differences in symptom scores between women with and without bacteriuria.

Results

Two hundred forty-seven women were recruited, aged 22–82. Sixteen of 247 urine samples (6.5%) demonstrated significant bacteriuria, growing a different range of organisms. Women with significant bacteriuria were more likely to have nocturia (OR 3.56, 95% CI 1.19–10.6, P = 0.02), urgency (OR 6.66, 95% CI 1.47–30.06, P = 0.01), bladder pain (OR 2.82, 95% CI 1–7.92, P = 0.049), urgency incontinence (OR 2.92, 95% CI 1.02–8.36, P = 0.046), nocturnal enuresis (OR 4.21, 95% CI 1.32–13.41, P = 0.01). After adjustment for age, parity, symptomatic prolapse, menopausal status and history of mid-urethral sling urinary urgency, bladder pain, nocturia, and nocturnal enuresis remained significantly associated.

Conclusions

Bacteriuria is associated with a range of LUTS including nocturia, urgency, and bladder pain supporting a role for bacterial colonization in the pathogenesis of OAB symptoms. Neurourol. Urodynam. 34:429–433, 2015. © 2014 Wiley Periodicals, Inc.

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