A team led by researchers at the University of Kent has identified bacterial infection as a possible cause of Overactive Bladder Syndrome (OAB).

OAB is a condition where the bladder muscle spontaneously contracts before the bladder is full. In the USA, it is ranked in the top 10 of common chronic conditions, competing with both diabetes and depression, with a reported prevalence of up to 31-42% in the adult population.

The researchers, including the Kent team from the Medway School of Pharmacy, found that some OAB patients had a low-grade inflammation which is missed by conventional NHS tests. This low-grade inflammation may ultimately result in increased sensory nerve excitation and the symptoms of OAB.

The study found that in these patients the low-grade inflammation is associated with bacteria living inside the bladder wall. This was an observational study which means that no conclusions can be drawn about cause and effect. However, the findings may prompt the clinical re-classification of OAB and inform future therapeutic strategies. These might include protracted treatment with antibiotics to alleviate the symptoms of OAB in some individuals.
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Article: Altered urothelial ATP signalling in major subset of human overactive bladder patients with pyuria, American Journal of Physiology, Alberto Contreras-Sanz, Louise Krska, Aswini A Balachandran, Natasha L. Curtiss, Rajvinder Khasriya, Stephen Kelley, Matthew Strutt, Hardyal S Gill, Kevin M Taylor, Kylie J Mansfield, Changhao Wu, Claire M Peppiatt-Wildman, James Malone-Lee, Jonathan Duckett, Scott S. Wildman PhD FASN, American Journal of Physiology, doi: 10.1152/ajprenal.00339.2015, published 29 June 2016.

Cigarette smoking is associated with an increased risk of overactive bladder (OAB) symptoms in women, according to a new British study.

In a retrospective study, Chendrimada Madhu, MD, of the Bristol Urological Institute, Southmead Hospital in Bristol, U.K., and colleagues analyzed data from 11,678 women who underwent urodynamic testing. Of these, 2,476 reported smoking cigarettes. Smoking cigarettes was associated with a significant 14% increased risk of OAB symptoms, 2.2 times increased risk of secondary nocturnal enuresis, and 14% increased risk of coital incontinence, Dr. Madhu's team reported online ahead of print in Urologia Internationalis.

Results showed that the most significant urodynamic findings were detrusor overactivity and detrusor overactivity incontinence. Compared with non-smokers, smokers had a significant 42% increased risk of detrusor overactivity and 42% increased risk of detrusor overactivity incontinence, according to the investigators.
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The researchers found no significant association between smoking and stress urinary incontinence or urodynamic stress incontinence.