title: Is chronic urinary infection a cause of overactive bladder?
abstract: Overactive bladder (OAB) is a diagnosis resulting from a combination of multiple underlying factors. Current traditional treatments are based on anticholinergic blockade which have marginal benefits and are associated with poor tolerability and continuation rates. There is mounting evidence that chronic low grade bacterial bladder colonisation may exacerbate OAB symptoms and may explain why the current treatment strategies are not always successful. However, standard diagnostic laboratory tests to identify the presence of such bacterial infection are unreliable. Newer technologies such as RNA sequencing and extended culture techniques, show that urine is not sterile and organisms that are found in urine may be responsible for OAB symptoms. This article aims to review the current evidence suggesting that micro-organisms in urine may be important in the aetiology of OAB or may exacerbate OAB symptoms.
authors.affiliation: Department of Obstetrics and Gynaecology, Medway Maritime Hospital, Gillingham, Kent ME7 5NY, UK. Electronic address: aswini@doctors.net.uk.
authors.forename: Aswini A
authors.initials: AA
authors.lastname: Balachandran
authors.affiliation: Medway School of Pharmacy, UK.
authors.forename: Scott S
authors.initials: SS
authors.lastname: Wildman
authors.affiliation: East Kent Hospitals University NHS Foundation Trust, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Strutt
authors.affiliation: Department of Obstetrics and Gynaecology, Medway Maritime Hospital, Gillingham, Kent ME7 5NY, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Duckett
mesh_terms: D002908:Chronic Disease; D005260:Female; D006801:Humans; D053201:Urinary Bladder, Overactive / Q000209:etiology* / Q000382:microbiology; D014552:Urinary Tract Infections / Q000150:complications* / Q000382:microbiology
keywords: Antibiotics; Detrusor overactivity; Infection; Intracellular bacteria; Overactive bladder; Urinary tract infection