Patients with Urinary Urgency Have Central Sensitization Symptoms-A LURN II Phenotyping Study.

PURPOSE: To examine central sensitization in patients with urinary urgency, with or without urgency urinary incontinence. MATERIALS AND METHODS: Adult male and female patients who presented with urinary urgency, with or without urgency incontinence, and seeking treatment for their overactive bladder (OAB) were enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) II Study. A control group without urgency or incontinence was also enrolled. Symptoms associated with central sensitization were assessed using the validated self-reported questionnaire Central Sensitization Inventory (CSI). CSI ≥ 40 is associated with a higher likelihood of having central sensitization. RESULTS: Six hundred seventeen cases with urinary urgency and 125 controls without urinary symptoms were included. Cases had higher CSI part A scores compared with controls (median 28.0 vs 15.0). The percentage of participants likely to have central sensitization (CSI ≥40) was significantly higher in cases vs controls (21% vs 3.2%, P < .001). About one-fourth of OAB cases had symptoms consistent with central sensitization with CSI ≥ 40. CSI ≥ 40 was associated with roughly 9 times the odds of being an urgency case compared with CSI < 40 (odds ratio 9.17, P < .001). Higher central sensitization scores correlated with more severe OAB-questionnaire (OAB-q symptom severity, ρ = 0.30, P < .001), urgency symptoms (LURN SI-29 subscale, ρ = 0.25, P < .001), incontinence symptoms (LURN SI-29 subscale, ρ = 0.24, P < .001), and worse quality of life (OAB-q health-related quality of life, ρ = -0.40, P < .001). CONCLUSIONS: Patients with OAB patients with urinary urgency had more central sensitization symptoms compared with controls. Our data suggested that central sensitization may play a role in at least a subset of patients with urinary urgency, with or without urgency urinary incontinence.

Duke Scholars

Author Cindy Louise Amundsen Obstetrics and Gynecology, Urogynecology

Author John E Jelovsek Obstetrics and Gynecology, Urogynecology