Sorrentino Felice, Cartwright Rufus, Digesu G Alessandro, Tolton Louise, Franklin Larissa, Singh Anand, Greco Pantaleo, Khullar Vik
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.
Neurourol Urodyn. 2015 Jun;34(5):429-33. doi: 10.1002/nau.22607. Epub 2014 Apr 9.
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.
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.
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.
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.
既往研究已注意到膀胱过度活动症诊断与菌尿症之间存在关联，但对于菌尿症与特定下尿路症状（LUTS）之间的关系了解甚少。我们推测，女性菌尿症会与多种LUTS的自我报告症状评分增加相关。
从二级医疗机构的普通妇科和泌尿妇科门诊招募女性。女性完成12项女性下尿路症状国际尿失禁咨询问卷，并提供清洁中段尿标本用于显微镜检查和培养。排除患有急性尿路感染的女性。采用三种统计方法（曼-惠特尼U检验、多变量逻辑回归和受试者工作特征曲线）评估有菌尿症和无菌尿症女性的症状评分差异。
招募了247名年龄在22至82岁之间的女性。247份尿液样本中有16份（6.5%）显示有显著菌尿症，培养出不同种类的微生物。有显著菌尿症的女性更有可能出现夜尿症（比值比[OR]3.56，95%置信区间[CI]1.19 - 10.6，P = 0.02）、尿急（OR 6.66，95% CI 1.47 - 30.06，P = 0.01）、膀胱疼痛（OR 2.82，95% CI 1 - 7.92，P = 0.049）、急迫性尿失禁（OR 2.92，95% CI 1.02 - 8.36，P = 0.046）、夜间遗尿（OR 4.21，95% CI 1.32 - 13.41，P = 0.01）。在调整年龄、产次、症状性脱垂、绝经状态和中段尿道吊带术病史后，尿急、膀胱疼痛、夜尿症和夜间遗尿仍显著相关。
菌尿症与一系列LUTS相关，包括夜尿症、尿急和膀胱疼痛，这支持细菌定植在膀胱过度活动症症状发病机制中的作用。
