title: Overactive bladder and autonomic dysfunction: Lower urinary tract symptoms in females with postural tachycardia syndrome.
abstract: Postural Tachycardia Syndrome (POTS) represents an autonomic disorder predominantly affecting females between 15 and 50 years of age. POTS is a chronic disorder (>6 months) characterized by an excessive heart rate increment on standing (>30 beats/min) in the presence of characteristic symptoms of cerebral hypoperfusion or sympathetic activation. Patients have clinically been noted to describe lower urinary tract symptoms (LUTS), although urologic symptoms have not been methodically assessed in the POTS population. Herein, we present data from a pilot study designed to identify and quantitate overactive bladder (OAB) in patients diagnosed with POTS.
  
  
  
  Patients admitted to the Vanderbilt Autonomic Dysfunction Center between June 2009 and October 2010 for evaluation for the potential diagnosis of POTS completed a validated, standardized questionnaire for OAB (OAB-q) at presentation. Symptom score and subscale analyses were conducted. Subscale health related quality of life (HRQL) scores were transformed into a 0-100 scale, with higher scores reflecting superior HRQL. Data are presented as mean ± SD.
  
  
  
  Thirty-two females presented for evaluation of symptoms consistent with POTS. Twenty-nine women were subsequently diagnosed with POTS with 19 of these patients completing the OAB-q questionnaire (65.5% response rate). Average age was 33.5 ± 8.3 years. Symptom severity transformed score was 26.0 ± 16.4, with 13 of 19 patients (68.4%) meeting clinical criteria for diagnosis of probable clinically significant OAB. Nocturia was the most bothersome symptom, followed by increased daytime frequency and urgency.
  
  
  
  This pilot study describes bothersome lower urinary tract dysfunction in patients presenting with POTS as assessed by patient-reported questionnaire data. Nocturia demonstrated the greatest negative impact on health-related quality of life (HRQL), while social interaction was the least affected HRQL domain. In patients with dysautonomia, this data provides a critical baseline for mechanistic insight into both disease-specific and global pathophysiology of nocturia and OAB. Neurourol. Urodynam. 36:610-613, 2017. © 2016 Wiley Periodicals, Inc.
authors: Department of Urologic Surgery, Vanderbilt University, Nashville, Tennessee.
authors: Melissa R
authors: MR
authors: Kaufman
authors: Division of Urology, Albany Medical College, Albany, New York.
authors: Laura
authors: L
authors: Chang-Kit
authors: Department of Medicine, Vanderbilt Medical Center, Nashville, Tennessee.|Department of Pharmacology, Vanderbilt Medical Center, Nashville, Tennessee.
authors: Satish R
authors: SR
authors: Raj
authors: Department of Medicine, Vanderbilt Medical Center, Nashville, Tennessee.
authors: Bonnie K
authors: BK
authors: Black
authors: Department of Urologic Surgery, Vanderbilt University, Nashville, Tennessee.
authors: Douglas F
authors: DF
authors: Milam
authors: Department of Urologic Surgery, Vanderbilt University, Nashville, Tennessee.
authors: W Stuart
authors: WS
authors: Reynolds
authors: Department of Medicine, Vanderbilt Medical Center, Nashville, Tennessee.|Department of Pharmacology, Vanderbilt Medical Center, Nashville, Tennessee.
authors: Italo
authors: I
authors: Biaggioni
authors: Department of Medicine, Vanderbilt Medical Center, Nashville, Tennessee.|Department of Pharmacology, Vanderbilt Medical Center, Nashville, Tennessee.|Department of Neurology, Vanderbilt Medical Center, Nashville, Tennessee.
authors: David
authors: D
authors: Robertson
authors: Department of Urologic Surgery, Vanderbilt University, Nashville, Tennessee.
authors: Roger R
authors: RR
authors: Dmochowski
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D010865:Pilot Projects; D054972:Postural Orthostatic Tachycardia Syndrome / Q000150:complications* / Q000503:physiopathology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology
keywords: OAB-q; Postural Tachycardia Syndrome; autonomic dysfunction; overactive bladder