Associations between individual lower urinary tract symptoms and bacteriuria in random urine samples in women.
OBJECTIVE
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.
Department of Urogynaecology, St Mary's Hospital, London, United Kingdom.|Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynaecology, University of Foggia, Foggia, Italy.
Felice
F
Sorrentino
Department of Urogynaecology, St Mary's Hospital, London, United Kingdom.|Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom.
Rufus
R
Cartwright
Department of Urogynaecology, St Mary's Hospital, London, United Kingdom.
G Alessandro
GA
Digesu
Institute for Reproductive and Developmental Biology, Imperial College London, London, United Kingdom.
Louise
L
Tolton
Women's Health Research Centre, Imperial College London, London, United Kingdom.
Larissa
L
Franklin
Department of Urogynaecology, St Mary's Hospital, London, United Kingdom.
Anand
A
Singh
Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynaecology, University of Foggia, Foggia, Italy.
Pantaleo
P
Greco
Department of Urogynaecology, St Mary's Hospital, London, United Kingdom.
Vik
V
Khullar
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058345:Asymptomatic Infections / Q000453:epidemiology*; D001437:Bacteriuria / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D053158:Nocturia / Q000453:epidemiology*; D053206:Nocturnal Enuresis / Q000453:epidemiology*; D010146:Pain / Q000453:epidemiology*; D053202:Urinary Incontinence, Urge / Q000453:epidemiology*; D055815:Young Adult
LUTS; OAB; bacteriuria; incontinence; urinary tract infection