Patients with osteoarthritis more likely to develop overactive bladder
Key takeaways:
- Patients with overactive bladder had an odds ratio of 1.4 for osteoarthritis.
- Overactive bladder was not associated with immune-related forms of arthritis, suggesting a mechanical link.
Patients with osteoarthritis, but not immune-related arthritis, demonstrate increased odds for developing overactive bladder vs. those without, according to data spanning 15 years published in Science Reports.
“Urine frequency, urgency and increased nocturia are the primary symptoms of [overactive bladder (OAB)], a common urological condition that that may or may not be accompanied with urge urine incontinence,” Yifan Sun, of the department of urology at Jiangnan University Medical Center, in China, and colleagues wrote. “It is highly prevalent, affecting up to 12% of adults, and has a severe reduction in quality of life. ... However, the pathogenesis of OAB remains unknown.
“A study conducted by Frank et al. found that the incidence of urinary incontinence is higher among elderly arthritis patients, which may be related to their level of disability,” they added. “In the survey, 38% of RA patients, 47% of OA patients, and 34% of soft tissue rheumatism patients reported difficulties in controlling urination, indicating that urinary incontinence is a common and often underestimated issue among arthritis patients. ... However, there are few studies on the relationship between OAB and arthritis.”
To better understand what they described as the “complex link” between the OAB and arthritis, Sun and colleagues conducted a cross-sectional study of 24,436 U.S. individuals — 3,975 with overactive bladder and 20,461 without — using data from the CDC’s National Health and Nutrition Examination Survey (NHANES) from 2005 to 2020.
Cases of arthritis were identified through questionnaires, while overactive bladder was diagnosed using the Overactive Bladder Symptom Score, calculated from responses to NHANES questionnaires on urinary incontinence. The relationship between the two was evaluated using weighted logistic regression.
The average age of respondents included in the study was 44.89 years, while 47.88% were women.
Overall, 35.37% patients with overactive bladder had arthritis vs. 15.64% of those without overactive bladder, according to the researchers. After adjusting for demographics, comorbidities and lifestyle factors, the researchers found there was a positive relationship between overactive bladder and any type of arthritis (OR = 1.37; 95% CI, 1.22-1.54).
The only specific type of arthritis with a significant positive relationship was OA (OR = 1.4; 95% CI, 1.22-1.62). There were no significant links between overactive bladder and rheumatoid arthritis (OR = 1.2; 95% CI, 0.99-1.46) or psoriatic arthritis (OR = 1.4; 95% CI, 0.75-2.6).
According to the researchers, urologists should consider assessing patients’ musculoskeletal status if they present with overactive bladder.
“Patients with osteoarthritis experience significant limitations in activity due to pain and joint dysfunction, leading to long-term lack of muscle exercise,” Sun and colleagues wrote. “We speculate that pelvic muscle atrophy associated with osteoarthritis may affect normal bladder function and increase the risk of OAB. ... Since the occurrence of OAB may be more influenced by mechanical factors and metabolic status, this may explain why OA is associated with OAB, while the association between immune-related arthritis and OAB is not significant.
“Our research suggests that patients with osteoarthritis may have a higher likelihood of developing OAB compared to those without arthritis, indicating a potential association between these two conditions,” they added. “Therefore, urologists should assess the musculoskeletal status of patients with OAB during diagnosis and treatment. Further large-scale, prospective studies are needed to confirm these findings.”
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