The association between overactive bladder and fibromyalgia: A systematic review and meta-analysis

Black box in overactive bladder: Central sensitization and its relationship with urinary symptom severity and quality of life

AIM

To examine central sensitization (CS), and to investigate the relationship between CS, and urinary symptom severity, and quality of life (QoL) in women with overactive bladder (OAB).

MATERIALS AND METHODS

A total of 144 women with OAB included the study. CS with the Central Sensitization Inventory (CSI), urinary symptom with the Overactive Bladder Questionnaire-Version 8 (OAB-V8), bladder diary and Patients' Perception of Intensity of Urgency Scale (PPIUS) and QoL with the King's Health Questionnaire (KHQ) were assessed.

RESULTS

It was found that 47.9% (n = 69) of women with OAB had CS. It was observed that the CSI score was related to the OAB-V8 score (ρ = 0.327; p < 0.001) and the average number of voids/day (ρ = 0.291; p < 0.001). Additionally, urgency severity was higher in women with OAB with CS than in women with OAB without CS (p = 0.006). There was a relationship between the CSI score and KHQ-incontinence impact (ρ = 0.250; p = 0.012), KHQ-personal relationship (ρ = 0.253; p = 0.002), KHQ-sleep/energy (ρ = 0.180; p = 0.031), KHQ-emotional state (ρ = 0.310; p < 0.001) and KHQ-severity measurement scores (ρ = 0.391; p < 0.001).

CONCLUSION

In this study, it was observed that the majority of women with OAB had CS. It was found that more severe symptoms of CS were associated with worse urinary symptom severity and QoL in these patients. It may be beneficial to evaluate CS in the management of OAB and to consider CS when determining treatment strategies.

Fibromyalgia - etiology, diagnosis and treatment including perioperative management in patients with fibromyalgia

Fibromyalgia (FM) is considered a multifactorial disorder/syndrome with not fully understood etiology. Chronic generalized pain is the main symptom. A broad spectrum of factors is proposed to explain the etiology. Its multifactorial nature is inherently associated with challenges in diagnosis and therapy. Various evidence of etiology has been evaluated with the aim of establishing a novel therapeutic approach. The main issue in the diagnosis and management is to focus on the evaluation of strict diagnostic criteria to minimize under- and overdiagnosis. Fibromyalgia is a challenge for perioperative management because of the increased risk of possible complications and poorer outcomes, including postoperative pain chronification. The authors have proposed an up-to-date evaluation of perioperative management considering the current guidelines. Multimodal analgesia combined with tailored perioperative care is the most appropriate assessment. Interdisciplinary research with special interest in pain management, including perioperative medicine, seems to be the main theme for the future.