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

Sorrentino, Felice; Cartwright, Rufus; Digesu, G. Alessandro; Tolton, Louise; Franklin, Larissa; Singh, Anubha; Greco, Pantaleo; Khullar, Vik

doi:10.1002/nau.22607

“…Sequencing of urine samples collected using specific techniques to avoid vaginal contaminants, from patients and healthy volunteers, has revealed a wide range of colonizing organisms that might be implicated in lower urinary tract dysfunction 48 . Evidence of exacerbation of lower urinary tract symptoms (LUTS) in association with both planktonic bacteria in the urine and urothelial colonization by bacteria has been reported 49–51 , but it remains unclear which species of bacteria may be responsible.…”

Section: Mechanisms/pathophysiologymentioning

confidence: 99%

Urinary incontinence in women

Aoki

¹

,

Brown

²

,

Brubaker

³

et al. 2017

Nat Rev Dis Primers

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Urinary incontinence symptoms are highly prevalent among women, have a substantial effect on health-related quality of life and are associated with considerable personal and societal expenditure. Two main types are described: stress urinary incontinence, in which urine leaks in association with physical exertion, and urgency urinary incontinence, in which urine leaks in association with a sudden compelling desire to void. Women who experience both symptoms are considered as having mixed urinary incontinence. Research has revealed overlapping potential causes of incontinence, including dysfunction of the detrusor muscle or muscles of the pelvic floor, dysfunction of the neural controls of storage and voiding, and perturbation of the local environment within the bladder. A full diagnostic evaluation of urinary incontinence requires a medical history, physical examination, urinalysis, assessment of quality of life and, when initial treatments fail, invasive urodynamics. Interventions can include non-surgical options (such as lifestyle modifications, pelvic floor muscle training and drugs) and surgical options to support the urethra or increase bladder capacity. Future directions in research may increasingly target primary prevention through understanding of environmental and genetic risks for incontinence.

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“…Sequencing of urine samples collected using specific techniques to avoid vaginal contaminants, from patients and healthy volunteers, has revealed a wide range of colonizing organisms that might be implicated in lower urinary tract dysfunction 48 . Evidence of exacerbation of lower urinary tract symptoms (LUTS) in association with both planktonic bacteria in the urine and urothelial colonization by bacteria has been reported [49][50][51] , but it remains unclear which species of bacteria may be responsible.…”

Section: Urgency Urinary Incontinencementioning

confidence: 99%

Urinary incontinence in women

Ss

¹

,

Rm²

2017

Nat Rev Dis Primers

15

0

1

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Urinary incontinence symptoms are highly prevalent among women, have a substantial effect on health-related quality of life and are associated with considerable personal and societal expenditure. Two main types are described: stress urinary incontinence, in which urine leaks in association with physical exertion, and urgency urinary incontinence, in which urine leaks in association with a sudden compelling desire to void. Women who experience both symptoms are considered as having mixed urinary incontinence. Research has revealed overlapping potential causes of incontinence, including dysfunction of the detrusor muscle or muscles of the pelvic floor, dysfunction of the neural controls of storage and voiding, and perturbation of the local environment within the bladder. A full diagnostic evaluation of urinary incontinence requires a medical history, physical examination, urinalysis, assessment of quality of life and, when initial treatments fail, invasive urodynamics. Interventions can include non-surgical options (such as lifestyle modifications, pelvic floor muscle training and drugs) and surgical options to support the urethra or increase bladder capacity. Future directions in research may increasingly target primary prevention through understanding of environmental and genetic risks for incontinence.Correspondence to R.C. Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London W2 1PG, UK. r.cartwright@imperial.ac.uk. Author contributions Competing interestsThe authors declare no competing interests. Publisher's noteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. HHS Public AccessAuthor manuscript Nat Rev Dis Primers. Author manuscript; available in PMC 2018 April 01. Published in final edited form as:Nat Rev Dis Primers. ; 3: 17042. doi:10.1038/nrdp.2017.42. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptUrinary incontinence is the complaint of involuntary loss (leakage) of urine 1 . The condition occurs in both sexes, but is much more frequent in women. Although some overlap in pathophysiology is evident between sexes, incontinence in men is often a consequence of prostatic enlargement or from damage to continence mechanisms during surgery or radiotherapy for prostate cancer. By contrast, incontinence in women is typically related to dysfunction of the bladder or pelvic floor muscles, with such dysfunction often arising during pregnancy or childbirth, or at the time of menopause. This Primer focuses on female urinary incontinence because of its higher prevalence and unique pathophysiology.There are two main subtypes of urinary incontinence: stress incontinence and urgency incontinence. According to the International Urogynecological Association (IUGA) and the International Continence Society (ICS) standard definition, stress incontinence is the complaint of urine leakage in association with coughing, sneezing or physical exertion, whereas urgency incontinence is the comp...

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“…Their findings suggested that women with recurrent UTI should endure evaluation and treatment of episodes of infection to prevent the development of oversensitive detrusor. Other studies showed that positive urine culture at 10 5 CFU/ml in women is significantly associated with lower urinary tract symptoms, such as nocturia, urgency, urgency incontinence, and nocturnal enuresis [21,22]. Additionally, bacteriuria is also associated with bladder pain.…”

Section: Chronic Inflammation and Nonsteroidal Anti-inflammatory Drugsmentioning

confidence: 99%

The Association between Chronic Inflammation and Recurrent Cystitis in Women

Chung

¹

2016

Urogenit Tract Infect

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Recurrent urinary tract infection is a common infectious disease seen in the clinic. It is very prevalent in women; as many as 15% of women develop urinary tract infection each year, and at least 25% have one or more recurrences. Chronic inflammation and increased urothelial apoptosis reflect a common pathophysiology in various lower urinary tract dysfunctions, causing bladder storage symptoms. It has been suggested that chronic inflammation could be associated with overactive detrusor and increased levels of urinary nerve growth factor and creatinine. The level of urinary nerve growth factor may decrease after an effective antimuscarinic therapy. Recurrent urinary tract infection could be prevented by using nonsteroidal anti-inflammatory drugs or cyclooxygenase-2 inhibitors. Intravesical hyaluronate and chondroitin sulfate reduce the incidence of recurrent bacterial cystitis, and treatment with hyaluronate targets bacterial adherence to the bladder mucosa in interstitial cystitis/bladder pain syndrome. This article reviews the pathophysiology of chronic inflammation of the bladder and investigates the association between chronic inflammation and recurrent urinary tract infection.

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

Abstract: 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.

Cited by 21 publications

References 27 publications

Urinary incontinence in women

Urinary incontinence in women

Urinary incontinence in women

The Association between Chronic Inflammation and Recurrent Cystitis in Women

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