Top

BMC Urology

Published in:

Open Access 01-12-2015 | Research article

Correlation between psychological stress levels and the severity of overactive bladder symptoms

Authors: Henry Lai, Vivien Gardner, Joel Vetter, Gerald L Andriole

Published in: BMC Urology | Issue 1/2015

Abstract

Background

The relationship between psychological stress and interstitial cystitis/bladder pain syndrome (IC/BPS) has been well described. Even though there is some overlapping of symptoms between overactive bladder (OAB) and IC/BPS, there have been very few studies that specifically investigated the relationship between psychological stress and urinary symptoms in OAB patients who do not have pelvic pain. Here we examined the relationship between psychological stress levels and the severity of overactive bladder (OAB) symptoms.

Methods

Patients diagnosed with OAB (n=51), IC/BPS (n=27), and age-matched healthy controls (n=30) participated in a case control study that inquired about their psychological stress levels using the perceived stress scale (PSS). PSS reported by the three patient groups were compared. Among OAB patients, their responses on the PSS was correlated to OAB symptoms using the following questionnaires: 1) international consultation on incontinence – urinary incontinence (ICIQ-UI), 2) international consultation on incontinence – overactive bladder (ICIQ-OAB), 3) OAB-q short form, 4) urogenital distress inventory (UDI-6), 5) incontinence impact questionnaire (IIQ-7), 6) urgency severity scale (USS), 7) numeric rating scales of urgency symptom, and 8) frequency symptom. Spearman’s correlation tests were performed to examine the relationship between psychological stress levels and the severity of OAB symptoms.

Results

OAB patients reported psychological stress levels that were as high as IC/BPS patients (median 17.0 versus 18.0, p=0.818, Wilcoxon sum rank test), and significantly higher than healthy controls (17.0, versus 7.5, p=0.001). Among OAB patients, there was a positive correlation between perceived stress levels and urinary incontinence symptoms (ICIQ-UI, Spearman’s correlation coefficient=0.39, p=0.007), and impacts on quality of life (UDI-6, IIQ-7, OAB-q quality of life subscale; Spearman’s correlation coefficient=0.32, 0.31, 0.39, and p=0.028, 0.005, 0.029, respectively). No significant correlation was observed between perceived stress levels and urgency or frequency symptoms (ICIQ-OAB, USS, numeric ratings of urgency and frequency).

Conclusions

OAB patients reported psychological stress levels that were as high as IC/BPS patients, and significantly higher than healthy controls. There was a positive correlation between perceived stress levels and urinary incontinence symptoms, and its impacts on quality of life among OAB patients.

Koziol JA, Clark DC, Gittes RF, Tan EM. The natural history of interstitial cystitis: a survey of 374 patients. J Urol. 1993;149:465–9.PubMed

Lutgendorf SK, Kreder KJ, Rothrock NE, Ratliff TL, Zimmerman B. Stress and symptomatology in patients with interstitial cystitis: a laboratory stress model. J Urol. 2000;164:1265–9.CrossRefPubMed

Rothrock NE, Lutgendorf SK, Kreder KJ, Ratliff T, Zimmerman B. Stress and symptoms in patients with interstitial cystitis: a life stress model. Urology. 2001;57:422–7.CrossRefPubMed

Lai HH, Vetter J, Jain S, Gereau RW, Andriole GL. The overlap and distinction of self-reported symptoms between interstitial cystitis/bladder pain syndrome and overactive bladder: a questionnaire-based analysis. J Urol. 2014;192(6):1679–85.CrossRefPubMedPubMedCentral

Knight S, Luft J, Nakagawa S, Katzman WB. Comparisons of pelvic floor muscle performance, anxiety, quality of life and life stress in women with dry overactive bladder compared with asymptomatic women. BJU Int. 2012;109:1685–9.CrossRefPubMed

Zhang C, Hai T, Yu L, Liu S, Li Q, Zhang X, et al. Association between occupational stress and risk of overactive bladder and other lower urinary tract symptoms: a cross-sectional study of female nurses in China. Neurourol Urodyn. 2013;32(3):254–60.CrossRefPubMed

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Am J Obstet Gynecol. 2002;187:116–26.CrossRefPubMed

Hanno PM, Burks DA, Clemens JQ, Dmochowski RR, Erickson D, Fitzgerald MP, et al. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol. 2011;185:2162–70.CrossRefPubMed

Gormley EA, Lightner DJ, Burgio KL, Chai TC, Clemens JQ, Culkin DJ, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol. 2012;188:2455–63.CrossRefPubMed

10.

Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, editors. The social psychology of health: Claremont symposium on applied social psychology. Newbury Parl, CA: Sage; 1988.

11.

Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23:322–30.CrossRefPubMed

12.

Jackson S, Donovan J, Brookes S, Eckford S, Swithinbank L, Abrams P. The Bristol Female Lower Urinary Tract Symptoms questionnaire: development and psychometric testing. Br J Urol. 1996;77:805–12.CrossRefPubMed

13.

Coyne K, Revicki D, Hunt T, Corey R, Stewart W, Bentkover J, et al. Psychometric validation of an overactive bladder symptom and health-related quality of life questionnaire: the OAB-q. Qual Life Res. 2002;11:563–74.CrossRefPubMed

14.

Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA. Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourol Urodyn. 1995;14:131–9.CrossRefPubMed

15.

Nixon A, Colman S, Sabounjian L, Sandage B, Schwiderski UE, Staskin DR, et al. A validated patient reported measure of urinary urgency severity in overactive bladder for use in clinical trials. J Urol. 2005;174:604–7.CrossRefPubMed

16.

Pennebaker JW, Susman JR. Disclosure of traumas and psychosomatic processes. Soc Sci Med. 1988;26:327–32.CrossRefPubMed

17.

Snaith RP, Zigmond AS. The hospital anxiety and depression scale. Br Med J (Clin Res Ed). 1986;292:344.CrossRef

18.

R: A language and environment for statistical computation. [http://www.R-project.org/]

19.

Baker J, Costa D, Nygaard I. Mindfulness-based stress reduction for treatment of urinary urge incontinence: a pilot study. Female Pelvic Med Reconstr Surg. 2012;18:46–9.CrossRefPubMed

20.

Smith AL, Leung J, Kun S, Zhang R, Karagiannides I, Raz S, et al. The effects of acute and chronic psychological stress on bladder function in a rodent model. Urology. 2011;78:967. e961-967.CrossRefPubMedPubMedCentral

21.

Robbins M, DeBerry J, Ness T. Chronic psychological stress enhances nociceptive processing in the urinary bladder in high-anxiety rats. Physiol Behav. 2007;91:544–50.CrossRefPubMedPubMedCentral

22.

Merrill L, Malley S, Vizzard MA. Repeated variate stress in male rats induces increased voiding frequency, somatic sensitivity, and urinary bladder nerve growth factor expression. Am J Physiol Regul Integr Comp Physiol. 2013;305:R147–56.CrossRefPubMedPubMedCentral

23.

Wood SK, Baez MA, Bhatnagar S, Valentino RJ. Social stress-induced bladder dysfunction: potential role of corticotropin-releasing factor. Am J Physiol Regul Integr Comp Physiol. 2009;296:R1671–8.CrossRefPubMedPubMedCentral

24.

Klausner AP, Steers WD. Corticotropin releasing factor: a mediator of emotional influences on bladder function. J Urol. 2004;172:2570–3.CrossRefPubMed

25.

Saini R, Gonzalez RR, Te AE. Chronic pelvic pain syndrome and the overactive bladder: the inflammatory link. Curr Urol Rep. 2008;9:314–9.CrossRefPubMed

26.

Lutgendorf SK, Kreder KJ, Rothrock NE, Hoffman A, Kirschbaum C, Sternberg EM, et al. Diurnal cortisol variations and symptoms in patients with interstitial cystitis. J Urol. 2002;167:1338–43.CrossRefPubMed

Title: Correlation between psychological stress levels and the severity of overactive bladder symptoms
Authors: Henry Lai
Vivien Gardner
Joel Vetter
Gerald L Andriole
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Urology / Issue 1/2015
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-015-0009-6

At a glance: The STEP trials

Springer Medicine

Correlation between psychological stress levels and the severity of overactive bladder symptoms

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2015

Extravascular stent management for migration of left renal vein endovascular stent in nutcracker syndrome

Prevalence of human papillomavirus in penile malignant tumors: viral genotyping and clinical aspects

Rethinking of ureteral stent removal using an extraction string; what patients feel and what is patients' preference? : a randomized controlled study

The ProCaSP study: quality of life outcomes of prostate cancer patients after radiotherapy or radical prostatectomy in a cohort study

Spleen injury following left extracorporeal shockwave lithotripsy (ESWL)

Quantitative volumetric imaging of normal, neoplastic and hyperplastic mouse prostate using ultrasound