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Zhang Y, Wu X, Liu G, Feng X, Jiang H, Zhang X. Association between overactive bladder and depression in American adults: A cross-sectional study from NHANES 2005-2018. J Affect Disord 2024; 356:545-553. [PMID: 38642902 DOI: 10.1016/j.jad.2024.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/12/2024] [Accepted: 04/08/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND AND AIM Overactive bladder (OAB) and depression are both common disorders and there is research suggesting an association between the two, but there is a lack of studies with large samples. The aim of this study is to investigate the association between OAB and depressive symptoms. METHODS We used data from the National Health and Nutrition Examination Survey (NHANES) database for the period 2005 to 2018. OAB was characterized by the Overactive Bladder Symptom Score (OABSS, score > 3) and depression was diagnosed by the Patient Health Questionnaire (PHQ-9, score ≥ 10). There were three models employed in our analysis: (1) Crude model was unadjusted; (2) Model 1 was adjusted for age, sex, race/ethnicity, educational level, and marital status; (3) Model 2 was adjusted for factors in Model 1 plus the remained potential covariates. We used survey-weighted logistic regression models to assess the association between OAB and depression. Subsequently, subgroup analyses and smoothed curve analyses were used to evaluate the reliability of the findings. RESULTS Finally, a total of 6612 participants were included in our study, consisting of 1005 participants with diagnosis of OAB and 5607 participants without diagnosis of OAB. After adjusting for all covariates, there was a significant positive association between OAB and depression (OR: 2.89, 95 % CI: 1.91, 4.37). The severity of OAB was also positively associated with depression. Compared to participants without OAB, the fully adjusted ORs for depression were 2.76 (95 % CI: 1.64, 4.65) for those with mild OAB, 3.79 (95 % CI: 1.68, 8.55) for those with moderate OAB, and 5.21 (95 % CI: 1.39, 19.53) for those with severe OAB. CONCLUSIONS This study revealed a strong association between OAB and depression and a progressive increase in the risk of depression as the severity of OAB (mild, moderate, and severe) increased. Therefore, it is important for clinicians to recognize the assessment of OAB symptoms in patients who are at risk for or have developed depressive symptoms, as well as the mental health of patients with OAB.
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Affiliation(s)
- Yuyang Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China
| | - Xu Wu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China
| | - Guodong Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China
| | - Xingliang Feng
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
| | - Hui Jiang
- Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center, Beijing, China.
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, China; Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Anhui Medical University, Anhui Province, China.
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Parodi S, Kendall HJ, Terrone C, Heesakkers JPFA. What Is in the Pipeline on Investigational Neuromodulation Techniques for Lower Urinary Tract Dysfunction: A Narrative Review. Neuromodulation 2024; 27:267-272. [PMID: 37865890 DOI: 10.1016/j.neurom.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/10/2023] [Accepted: 09/18/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES Overactive bladder (OAB) affects millions of patients worldwide. Its treatment is challenging but improves the patient's quality of life. Besides standard techniques for neuromodulation (sacral and pudendal neuromodulation and posterior tibial nerve stimulation), several new techniques have been investigated to treat symptoms of refractory OAB. The purpose of the present review is to outline the state of the art of new neuromodulation techniques for lower urinary tract dysfunction (LUTD). MATERIALS AND METHODS In March 2023, a comprehensive MEDLINE, EMBASE, and Scopus search was carried out (keywords: LUTD, new technologies, neuromodulation, LUTS, OAB, painful bladder syndromes, etc). Articles were included according to inclusion (randomized controlled trials, prospective trials, large retrospective studies) and exclusion (case reports, outcomes not clearly expressed in full text, animal studies) criteria. The reference lists of the included studies also were scanned. Both adult and pediatric populations were included, in addition to both neurogenic and nonneurogenic OAB. A narrative review was then performed. RESULTS Peroneal neuromodulation, transcutaneous electrical nerve stimulation, magnetic nerve stimulation, and parasacral transcutaneous neuromodulation are the most studied investigative techniques and were shown to yield promising results in treating OAB symptoms. Most studies showed promising results even in the complex scenarios of patients with OAB refractory to standard treatments. Comparing investigational techniques with standard of care and their respective clinical outcomes and safety profiles, and confronting their pros and cons, we reasonably believe that once such treatment modalities are further developed, they could play a role in the OAB treatment algorithm. CONCLUSIONS Although the described neuromodulation techniques are being intensely studied, the available results are not yet sufficient for any guidelines to recommend their use.
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Affiliation(s)
- Stefano Parodi
- Department of Urology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; University Medical Center, Maastricht, The Netherlands.
| | | | - Carlo Terrone
- Department of Urology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Kalata U, Pomian A, Jarkiewicz M, Kondratskyi V, Lippki K, Barcz E. Influence of Stress Urinary Incontinence and Pelvic Organ Prolapse on Depression, Anxiety, and Insomnia-A Comparative Observational Study. J Clin Med 2023; 13:185. [PMID: 38202192 PMCID: PMC10779935 DOI: 10.3390/jcm13010185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/06/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Among pelvic floor disorders (PFDs), overactive bladder is a well-recognized condition affecting mental health. The aim of this study was to assess whether there is a correlation between stress urinary incontinence (SUI), pelvic organ prolapse (POP), and mental health in comparison to control subjects and whether objective or subjective aspects of diseases are responsible for the aforementioned symptoms. METHODS 192 patients with SUI, 271 with symptomatic prolapse (>2 in the POPQ scale), and 199 controls without pelvic floor disorders were included in this study. Patients completed questionnaires assessing levels of depression, anxiety, and insomnia. The 1-h pad test and IIQ-7 questionnaires were collected in SUI. The pelvic organ prolapse quantification scale and the POPDI6, UDI6, and CRADI-8 questionnaires were used in POP patients. RESULTS Higher scores in psychiatric scales were observed in SUI (p < 0.05) and POP (p < 0.05) compared to control. There were no correlations between the objective severity of PFDs and psychological symptoms, while subjective complaints correlated with psychological health. In conclusion, we showed that subjective perceptions of SUI and POP are factors that augment psychiatric symptoms, while objective severity is not correlated with mental status. CONCLUSIONS Our findings suggest that patients with PFDs necessitate multidisciplinary attention, including psychiatric care.
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Affiliation(s)
- Urszula Kalata
- Chair of Gynecology and Obstetrics, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland; (U.K.); (A.P.); (V.K.); (K.L.)
| | - Andrzej Pomian
- Chair of Gynecology and Obstetrics, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland; (U.K.); (A.P.); (V.K.); (K.L.)
| | - Michał Jarkiewicz
- 3rd Department of Psychiatry, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland;
| | - Vitalii Kondratskyi
- Chair of Gynecology and Obstetrics, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland; (U.K.); (A.P.); (V.K.); (K.L.)
| | - Krzysztof Lippki
- Chair of Gynecology and Obstetrics, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland; (U.K.); (A.P.); (V.K.); (K.L.)
| | - Ewa Barcz
- Chair of Gynecology and Obstetrics, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland; (U.K.); (A.P.); (V.K.); (K.L.)
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Cunningham SD, Carandang RR, Boyd LM, Lewis JB, Ickovics JR, Rickey LM. Psychosocial Factors Associated with Lower Urinary Tract Symptoms One Year Postpartum. Int J Environ Res Public Health 2023; 21:40. [PMID: 38248505 PMCID: PMC10815698 DOI: 10.3390/ijerph21010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Pregnancy carries substantial risk for developing lower urinary tract symptoms (LUTSs), with potential lifelong impacts on bladder health. Little is known about modifiable psychosocial factors that may influence the risk of postpartum LUTSs. We examined associations between depressive symptoms, perceived stress, and postpartum LUTSs, and the moderating effects of perceived social support, using data from a cohort study of Expect With Me group prenatal care (n = 462). One year postpartum, 40.3% participants reported one or more LUTS. The most frequent LUTS was daytime frequency (22.3%), followed by urinary incontinence (19.5%), urgency (18.0%), nocturia (15.6%), and bladder pain (6.9%). Higher odds of any LUTS were associated with greater depressive symptoms (adjusted odds ratio (AOR) 1.08, 95% confidence interval (CI) 1.04-1.11) and perceived stress (AOR 1.12, 95% CI 1.04-1.19). Higher perceived social support was associated with lower odds of any LUTS (AOR 0.94, 95% CI 0.88-0.99). Perceived social support mitigated the adverse effects of depressive symptoms (interaction AOR 0.99, 95% CI 0.98-0.99) and perceived stress (interaction AOR 0.97, 95% CI 0.95-0.99) on experiencing any LUTS. Greater depressive symptoms and perceived stress may increase the likelihood of experiencing LUTSs after childbirth. Efforts to promote bladder health among postpartum patients should consider psychological factors and social support.
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Affiliation(s)
- Shayna D Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT 06030, USA
| | - Rogie Royce Carandang
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT 06030, USA
| | - Lisa M Boyd
- Virginia Polytechnic Institute, State University, Blacksburg, VA 24061, USA
| | - Jessica B Lewis
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA
| | - Jeannette R Ickovics
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - Leslie M Rickey
- Departments of Urology and Obstetrics, Gynecology & Reproductive Services, Yale School of Medicine, New Haven, CT 06510, USA
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Di Bello F, Scandurra C, Muzii B, Colla’ Ruvolo C, Califano G, Mocini E, Creta M, Napolitano L, Morra S, Fraia A, Bochicchio V, Salzano G, Vaira LA, Mangiapia F, Motta G, Motta G, Maldonato NM, Longo N, Cantone E. Are Excessive Daytime Sleepiness and Lower Urinary Tract Symptoms the Triggering Link for Mental Imbalance? An Exploratory Post Hoc Analysis. J Clin Med 2023; 12:6965. [PMID: 38002580 PMCID: PMC10672561 DOI: 10.3390/jcm12226965] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/04/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Both lower urinary tract symptoms (LUTS) and excessive daytime sleepiness (EDS) could negatively impair the patients' quality of life, increasing the sensitivity to psychological distress that results in mental health disorders. The relationships of both urinary and respiratory domains with psychological distress in obstructive sleep apnea patients is still underestimated. METHODS This study was a post hoc analysis of a web-based Italian survey, which included 1998 participants. Three hierarchical multiple linear regression analyses with psychological distress as dependent variable were performed on the study of 1988 participants enrolled in the final analysis. Cohen's f2 was used for the assessment of the effect size. RESULTS From the hierarchical multiple linear regression analyses, it emerged that the final statistical model (including sociodemographic characteristics, comorbidities, perceived urinary function, and excessive daytime sleepiness) for all dimensions accounted for 16.7% of the variance in psychological distress, with a medium effect size (f2 = 0.15). CONCLUSIONS People reported psychological distress was impaired by the presence of LUTS and EDS. Specifically, our study showed that higher levels of distress were scored especially in young women exhibiting urinary symptoms and with high values of daytime sleepiness.
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Affiliation(s)
- Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Cristiano Scandurra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Benedetta Muzii
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Claudia Colla’ Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University, 00185 Rome, Italy;
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Agostino Fraia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, 87036 Rende, Italy;
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy;
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy;
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Gaetano Motta
- ENT Unit, Department of Mental, Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.M.)
| | - Giovanni Motta
- ENT Unit, Department of Mental, Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (G.M.); (G.M.)
| | - Nelson Mauro Maldonato
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
| | - Elena Cantone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (F.D.B.); (C.S.); (C.C.R.); (G.C.); (M.C.); (L.N.); (S.M.); (A.F.); (F.M.); (N.M.M.); (N.L.); (E.C.)
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