Rogowski Artur, Krowicka-Wasyl Maria, Chotkowska Ewa, Kluz Tomasz, Wróbel Andrzej, Berent Dominika, Mierzejewski Paweł, Sienkiewicz-Jarosz Halina, Wichniak Adam, Wojnar Marcin, Samochowiec Jerzy, Kilis-Pstrusinska Katarzyna, Bienkowski Przemyslaw
Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland.
Department of Obstetrics and Gynecology, Mother and Child Institute, 01-211 Warsaw, Poland.
J Clin Med. 2021 Sep 3;10(17):3988. doi: 10.3390/jcm10173988.
A link between psychiatric comorbidities and overactive bladder symptomatology has been suggested by preclinical and clinical studies. Given this, we hypothesized that a psychiatric history and current treatment with psychotropic medications could be related to the severity of overactive bladder and incontinence symptoms in patients referred to a tertiary care urogynecological center.
One hundred and twenty-seven female patients diagnosed with an overactive bladder were screened for a lifetime history of psychiatric disorders and the type and number of psychotropic medications currently taken. The overall severity of overactive bladder symptoms was assessed using the Indevus Urgency Severity Scale. The severity and impact of urinary incontinence on the quality of life were quantified with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Urinary incontinence was further quantified with the aid of the Urinary Distress Inventory-6. The patients were screened for stress urinary incontinence using the Stamey Incontinence Score.
A psychiatric history, as well as current use of at least two psychotropic medications, was associated with increased severity of overactive bladder symptoms. A history of depression and current treatment with any selective serotonin reuptake inhibitor was associated with increased severity of stress urinary incontinence symptoms. Current treatment with other psychotropic medications, including sedative-hypnotics and drugs with anticholinergic properties was not related to the severity of overactive bladder and incontinence symptoms.
临床前和临床研究表明精神疾病合并症与膀胱过度活动症症状之间存在联系。鉴于此，我们推测精神病史和目前使用精神药物治疗可能与转诊至三级护理泌尿妇科中心的患者膀胱过度活动症及尿失禁症状的严重程度有关。
对127名被诊断为膀胱过度活动症的女性患者进行筛查，了解其精神疾病的终生病史以及目前服用的精神药物的类型和数量。使用因德弗斯尿急严重程度量表评估膀胱过度活动症症状的总体严重程度。使用国际尿失禁咨询问卷-尿失禁简表量化尿失禁对生活质量的严重程度和影响。借助尿困扰量表-6进一步量化尿失禁情况。使用斯塔梅尿失禁评分对患者进行压力性尿失禁筛查。
精神病史以及目前至少使用两种精神药物与膀胱过度活动症症状严重程度增加有关。抑郁症病史和目前使用任何选择性5-羟色胺再摄取抑制剂与压力性尿失禁症状严重程度增加有关。目前使用其他精神药物，包括镇静催眠药和具有抗胆碱能特性的药物，与膀胱过度活动症和尿失禁症状的严重程度无关。
