The Influence Of Psychiatric Comorbidities And Sexual Trauma On Lower Urinary Tract Symptoms In Female Veterans

Main Category: Urology / Nephrology
Also Included In: Veterans / Ex-Servicemen;  Psychology / Psychiatry;  Sexual Health / STDs
Article Date: 27 Jan 2010 - 6:00 PDT

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UroToday.com - Psychosocial conditions including depression, anxiety disorders and sexual trauma have been identified as risk factors for overactive bladder and incontinence. Could psychosocial factors and emotional influences play a role in the production or perception of lower urinary tract symptoms? Davilla has reported that 72% of sexual abuse survivors reported incontinence vs. 22% of controls. (J Urol 2003:170:476). In a new publication, Adam Klausner and colleagues from Richmond, VA characterized the type, severity, and quality of life impact of lower urinary tract symptoms (LUTS) in patients with psychiatric comorbidities and/or sexual trauma. While the publication looks primarily at patients with urgency, frequency, and incontinence consistent with a diagnosis of overactive bladder, the potential applicability of the findings to bladder pain syndrome is intriguing.

The authors looked at the 128 female patients evaluated in a primary care clinic who were referred to a LUTS clinic for urinary urgency, urinary incontinence, and urinary frequency. Subjects were given validated questionnaires including the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7. Women referred for evaluation of lower urinary tract symptoms had higher rates of psychiatric comorbidities and sexual trauma compared to those in the primary care clinic with similar symptoms (308) who had not been referred. Higher Urogenital Distress Inventory-6 scores were associated only with age younger than 50 years and history of miscarriage, and higher Incontinence Impact Questionnaire-7 scores were associated only with psychiatric comorbidities and history of miscarriage. Although the rate of sexual trauma was nearly 50% of the population, the rate of psychiatric comorbidities was significantly higher in the 60 patients with a history of sexual trauma.

This interesting study demonstrates that psychosocial and emotional factors likely influence quality of life associated with overactive bladder, but not the type or severity of symptoms themselves. Could the same be true of bladder pain syndrome symptoms?

Klausner AP, Ibanez D, King AB, Willis D, Herrick B, Wolfe L, Grob BM

J Urol. 2009 Dec;182(6):2785-90
10.1016/j.juro.2009.08.035
Written by UroToday.com Contributing Editor Philip M. Hanno, MD, MPH

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