title: Systemic Nonurological Symptoms in Patients with Overactive Bladder.
abstract: OBJECTIVE
  We compare the systemic (nonurological) symptoms between patients with overactive bladder and subjects without overactive bladder. We also compare the urinary symptoms, quality of life and psychosocial measures between the 2 subgroups of patients with overactive bladder with a high vs low systemic symptom burden.
  
  
  METHODS
  Patients diagnosed with overactive bladder (51) and age matched individuals without overactive bladder (30) were administered the polysymptomatic, polysyndromic questionnaire to assess the numbers and distribution of systemic symptoms across multiple organ systems. Validated instruments were administered to evaluate urinary symptoms (ICIQ-UI, ICIQ-OAB, OAB-q, USS), quality of life (UDI-6, IIQ-7, OAB-q) and psychosocial difficulties (depression, anxiety, stress, sexual trauma, sleep, fatigue). Patients with overactive bladder were divided into 2 subgroups (with and without widespread systemic symptoms) and their responses were compared.
  
  
  RESULTS
  Patients with overactive bladder reported significantly more systemic (nonurological) symptoms compared to controls (mean ± SD 17.5 ± 12.3 vs 6.4 ± 7.9 symptoms, p <0.001). Differences were observed across multiple organ systems (neurologic, cardiopulmonary, gastrointestinal, sexual, musculoskeletal and gynecologic, p <0.05). About a third of patients with overactive bladder (31.4%) reported widespread systemic symptoms across multiple organ systems (mean 32.0 symptoms). The presence of widespread systemic symptoms among patients with overactive bladder was correlated with worse incontinence/overactive bladder symptoms (ICIQ-UI, OAB-q), poorer quality of life (UDI-6, IIQ-7, OAB-q) and more psychosocial difficulties (depression, anxiety, fatigue and higher stress, p <0.05).
  
  
  CONCLUSIONS
  The increased presence of nonurological symptoms in overactive bladder suggests an underlying systemic etiology and pathogenetic mechanisms that may contribute to overactive bladder. This study highlights the importance of understanding systemic factors in urological conditions otherwise thought to be organ specific.
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri; Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri. Electronic address: laih@wudosis.wustl.edu.
authors.forename: H Henry
authors.initials: HH
authors.lastname: Lai
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Joel
authors.initials: J
authors.lastname: Vetter
authors.affiliation: Renal Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Jain
authors.affiliation: Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Gerald L
authors.initials: GL
authors.lastname: Andriole
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D017281:Cost of Illness; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D053201:Urinary Bladder, Overactive / Q000150:complications* / Q000175:diagnosis / Q000523:psychology
keywords: comorbidity; psychosomatic medicine; signs and symptoms; urinary bladder, overactive; urinary incontinence