Perceived Stress and Accompanying Low Urine pH Are in Relation to Bladder Pain Syndrome (original) (raw)
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Association between stress and lower urinary tract symptoms in children and adolescents
International braz j urol, 2019
Introduction: Lower urinary tract dysfunction (LUTD) is a common clinical condition. Emotional and behavioral issues are increasing among children and adolescents, with stress indicating diffi culties in personal and social functioning. This study evaluated whether urinary tract symptoms (LUTS) is associated with stress. Materials and Methods: A cross-sectional, analytical study with 6-14-year-old patients with LUTS and no anatomical/neurogenic urinary tract abnormalities was conducted using the Dysfunctional Voiding Scoring System, a psychological assessment and the Child Stress Scale. The overall stress score was analyzed in relation to the psychological assessment data. Answers to the seven specifi c DVSS urinary questions were compared with those for the four Child Stress Scale domains. Univariate and multivariate analyses were performed. The chi-square test and Pearson's correlation were used to determine associations. Signifi cance was defi ned as p <0.05. Results: Most children were male (56%). Mean age was 9.0±2.25 years. Stress was detected in 20 out of 98 patients (20.4%; 95% CI: 13-30%).Of these, 90% were born from unplanned pregnancies and 67% were upset about their disorder. All the Child Stress Scale domains were signifi cantly associated with urinary dysfunction, with dysuria being signifi cantly associated with all four domains. In the multivariate analysis, dysuria was the only symptom that remained associated with stress. Associations with stress strengthened as the frequency of dysuria increased: physical reactions (p <0.01), emotional reactions (p <0.05), psychological reactions with a depressive component (p <0.01) and psychophysiological reactions (p <0.05). Conclusion: Stress levels are higher in children and adolescents with LUTS who have more severe symptoms. Dysuria was the symptom most associated with stress, both in the physical reactions domain, in the psychological reactions domains with or without a depressive component and in the psychophysiological reactions domain.
Bladder pain syndrome/interstitial cystitis is associated with anxiety disorder
2014
Background: Although the etiology of bladder pain syndrome/interstitial cystitis (BPS/IC) is still unclear, a common theme with BPS/IC patients is comorbid disorders which are related to the autonomic nervous system that connects the nervous system to end-organs. Nevertheless, no study to date has reported the association between hyperthyroidism and BPS/IC. In this study, we examined the association of IC/BPS with having previously been diagnosed with hyperthyroidism in Taiwan. Design: Data in this study were retrieved from the Longitudinal Health Insurance Database. Our study consisted of 736 female cases with BPS/IC and 2208 randomly selected female controls. We performed a conditional logistic regression to calculate the odds ratio (OR) for having previously been diagnosed with hyperthyroidism between cases and controls. Results: Of the 2944 sampled subjects, there was a significant difference in the prevalence of prior hyperthyroidism between cases and controls (3.3% vs. 1.5%, p,0.001). The conditional logistic regression analysis revealed that compared to controls, the OR for prior hyperthyroidism among cases was 2.16 (95% confidence interval (CI): 1.27,3.66). Furthermore, the OR for prior hyperthyroidism among cases was 2.01 (95% CI: 1.15,3.53) compared to controls after adjusting for diabetes, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraines, sicca syndrome, allergies, endometriosis, and asthma. Conclusions: Our study results indicated an association between hyperthyroidism and BPS/IC. We suggest that clinicians treating female subjects with hyperthyroidism be alert to urinary complaints in this population.
Stress and symptoms in patients with interstitial cystitis: a life stress model
Urology, 2001
Objectives. Stress-related exacerbation of interstitial cystitis (IC) symptoms has frequently been reported. Previous research has found stress-related IC symptom exacerbation in an experimental model. However, this relationship has not been objectively examined with daily life stressors. We used a prospective daily symptom diary method to investigate the relationships among stress and bladder symptoms in patients with IC and age-matched healthy controls. Methods. Forty-five previously diagnosed female patients with IC completed a bladder symptom and stress diary nightly for 1 month; 31 female age-matched healthy controls completed a similar diary for 7 days. The symptom questions were modified from the Interstitial Cystitis Data Base study. Results. Patients reported greater mean daily stress, bladder pain, urgency, and daytime and nocturnal frequency than controls (all P values less than 0.001). Among all patients, a significant relationship between stress and urgency was observed. In addition, a significant relationship between stress and pain was observed among patients with moderate and severe disease. As the disease severity increased, more pronounced relationships between stress and the symptoms of urgency and pain were evidenced. Greater stress was associated with greater nocturnal frequency among patients with more severe disease. These stress-symptom relationships were not observed among the controls. Conclusions. Higher levels of stress were related to greater pain and urgency in patients with IC but not in the controls. In addition, the relationship of stress and these IC symptoms was stronger among patients with more severe disease. The results indicate that life stress is associated with greater IC symptoms, particularly among patients whose disease is not well controlled. UROLOGY 57: 422-427, 2001.
The interaction of stress and urgency urinary incontinence and its effect on quality of life
International urogynecology journal, 2015
The objective was to estimate the impact of stress and urgency urinary incontinence (UI) on the quality of life (QOL), and to determine whether the impact varies according to UI severity. We used data from the General Longitudinal Overactive Bladder Evaluation-UI study in women. Stress and urgency UI symptom severity scores ranged from 0 to 8. We used logistic regression to test the relation among different severity levels of stress and urgency UI, and their interaction with the Incontinence Impact Questionnaire (IIQ-7). This was categorized according to percentage ranges as 0-40% (reference), 41-80%, and 81-100%. Both stress and urgency UI were significantly associated with IIQ-7. Higher scores had higher odds ratios (ORs). The OR for urgency vs stress UI was greater at the same severity level. For instance, comparing IIQ-7 quintiles (0-40% vs 41-80%), the OR for an association with an urgency UI score of 5-6 was 5.27 (95% CI = 3.78-7.33) vs 2.76 (95% CI = 2.07-3.68) for a stress U...
Neurourology and Urodynamics, 2007
Aims: Presently, there is no simple, universally accepted instrument for the initial diagnosis of urinary incontinence (UI), which is why physicians find it so difficult to integrate the diagnosis into their daily clinical practice. The objective of this study is to analyze the true value of the ICIQ-UI SF questionnaire (ICIQ), the stress test, and the combination of both for the diagnosis as to the type of UI. Methods: Cross-sectional study performed in 116 women consulting for UI symptoms in two specialized health care centers. The subjects completed the ICIQ and underwent a stress test and urodynamic testing which was used for the reference diagnosis. Sensitivity, specificity, positive and negative predictive values, and the statistical ''likelihood ratio (LR)'' were assessed. Results: According to the ICIQ, 45 women (38.8%) suffered from Stress UI (SUI); 19 (16.4%), Urgency UI (UUI), and 49 (42.2%), Mixed UI (MUI). According to the stress test, 75 (64.7%) presented SUI. According to the combination of both tests, the diagnosis was SUI in 35 (30.2%), UUI in 17 (14.7%), and MUI in 37 (31.9%). Regarding urodynamic testing, observations were as follows: USI in 45 subjects (38.8%), detrusor overactivity (DO) in 25 (21.6%), and combination of both (MUI) in 30 (25.9%). The combination of ICIQ-UI SF plus stress test showed good specificity and negative predictive value, and the best LR coefficients obtained were: 3.11 (USI); 6.64 (UUI); 2.64 (MUI), and 3.77 (''all'' SUI). Conclusions: The combined use of the ICIQ plus stress test will aid in characterizing the type of UI at a basic health care level, favoring the prescription of the most appropriate treatment for each case. Neurourol. Urodynam. 26:836-841, 2007. ß 2007
International Urogynecology Journal, 2016
Introduction and hypothesis-The aim of this study was to measure physiologic and psychologic stress reactivity in women with overactive bladder (OAB). There is growing evidence in preclinical models that central nervous system dysregulation, particularly in response to psychological stress, may contribute to lower urinary tract symptoms in women with OAB. Methods-Postmenopausal women with OAB and healthy controls underwent Structured Clinical Interview for DSM-IV Axis I disorders (SCID) to identify those without identifiable psychiatric disease. Eligible participants underwent physiologic measures including basal (cortisol-awakening response; CAR) and stress-activated salivary cortisol levels, heart rate (HR), urinary metanephrines and neurotrophins, as well as validated symptom assessment for stress,
Relationship Between Urinary Symptoms Reported in a Postal Questionnaire and Urodynamic Diagnosis
Neurourology and Urodynamics, 2005
Aims: To describe the relationship between symptoms reported in a self-completed postal questionnaire and urinary disorders based on urodynamic investigation. Methods: The study population was selected from women aged 40 years or over living in the community, who responded to a postal questionnaire. Following assessment and appropriate conservative interventions, those with a pre-de¢ned level of severity of symptoms were o¡ered urodynamic investigation. Logistic regression examined the association between urinary symptoms and the urodynamic diagnoses of detrusor overactivity (DO) and urodynamic stress incontinence (USI). Results: Four hundred eighty-eight women completed urodynamic investigation; 29.1% (142/488) were found to have DO, 33.6% (164/ 488) USI, 20.7% (101/488) mixed incontinence, and 16.6% (81/488) no urodynamic abnormality. Stress incontinence (SI) and urge incontinence (UI) were included in the risk model for USI. SI reported monthly or more was associated with increased risk of USI, and UI reported weekly or more with decreased risk (sensitivity 76.9%; speci¢city 56.3%; positive predictive value (PPV) 67.8%). For DO, strong or overwhelming urgency, UI monthly or more, and nocturia once a night or more were all signi¢cantly associated with an increased risk while reporting of SUI monthly or more reduced the risk (sensitivity 63.1%; speci¢city 65.1%; PPV 63.1%). Conclusions: Urinary symptoms reported in a postal questionnaire are able to predict urodynamic diagnoses with moderate accuracy. These models may be useful tools with which to categorize urinary disorders for epidemiological study and, with further development, allocate ¢rst line treatment. Neurourol. Urodynam. 24: 100^105, 2005.