Reynolds W Stuart, Mock Stephen, Zhang Xuechao, Kaufman Melissa, Wein Alan, Bruehl Stephen, Dmochowski Roger
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Division of Urology, Penn Medicine, Philadelphia, Pennsylvania.
Neurourol Urodyn. 2017 Apr;36(4):1113-1118. doi: 10.1002/nau.23060. Epub 2016 Jul 1.
Mechanisms underlying pain perception and afferent hypersensitivity, such as central sensitization, may impact overactive bladder (OAB) symptoms. However, little is known about associations between OAB symptom severity, pain experience, and presence of comorbid chronic pain syndromes. This study examined relationships between OAB symptoms, somatic symptoms, and specific chronic pain conditions in which central sensitization is believed to play a primary role, in a community-based sample of adult women with OAB.
We recruited adult women with OAB to complete questionnaires assessing urinary symptoms, pain and somatic symptoms, and preexisting diagnoses of central sensitivity syndromes. We analyzed the effects of overall bodily pain intensity, general somatic symptoms, and diagnoses of central sensitivity syndromes on OAB symptom bother and health-related quality of life.
Of the 116 women in this study, over half (54%) stated their urge to urinate was associated with pain, pressure, or discomfort. Participants reported a wide range of OAB symptoms and health-related quality of life. There was a significant, positive correlation between OAB symptoms and somatic symptoms as well as overall pain intensity. Only 7% of women met diagnostic criteria for fibromyalgia; yet these women demonstrated significantly increased OAB symptom burden and decreased OAB quality of life compared to those without fibromyalgia.
Women with more severe OAB symptoms reported increased general somatic symptom burden and increased overall body pain intensity, especially women with fibromyalgia. These findings suggest that attributes of pain and co-morbidity with chronic pain conditions may impact the experience of OAB symptoms for many women. Neurourol. Urodynam. 36:1113-1118, 2017. © 2016 Wiley Periodicals, Inc.
疼痛感知和传入超敏反应的潜在机制,如中枢敏化,可能会影响膀胱过度活动症(OAB)症状。然而,关于OAB症状严重程度、疼痛体验以及合并慢性疼痛综合征之间的关联,我们知之甚少。本研究在一个基于社区的成年女性OAB样本中,考察了OAB症状、躯体症状与特定慢性疼痛状况之间的关系,在这些慢性疼痛状况中,中枢敏化被认为起主要作用。
我们招募了患有OAB的成年女性,以完成评估泌尿系统症状、疼痛和躯体症状以及中枢敏感综合征既往诊断的问卷。我们分析了总体身体疼痛强度、一般躯体症状以及中枢敏感综合征诊断对OAB症状困扰和健康相关生活质量的影响。
在本研究的116名女性中,超过一半(54%)表示她们的排尿冲动与疼痛、压迫感或不适有关。参与者报告了广泛的OAB症状和健康相关生活质量。OAB症状与躯体症状以及总体疼痛强度之间存在显著的正相关。只有7%的女性符合纤维肌痛的诊断标准;然而,与没有纤维肌痛的女性相比,这些女性的OAB症状负担显著增加,OAB生活质量下降。
OAB症状更严重的女性报告了总体躯体症状负担增加和全身疼痛强度增加,尤其是患有纤维肌痛的女性。这些发现表明,疼痛特征和与慢性疼痛状况的共病可能会影响许多女性的OAB症状体验。《神经泌尿学与尿动力学》,2017年,第36卷,第1113 - 1118页。© 2016威利期刊公司。