Is chronic urinary infection a cause of overactive bladder?

Area of Science:

• Urology
• Microbiology
• Infectious Diseases

Background:

• Overactive bladder (OAB) is complex, with treatments like anticholinergic blockade offering limited success and poor adherence.
• Current diagnostic methods for bacterial infection in OAB are often unreliable.
• Emerging evidence suggests chronic, low-grade bacterial colonization may play a role in OAB etiology.

Purpose of the Study:

• To review current evidence linking urinary microorganisms to the causes or exacerbation of OAB symptoms.
• To highlight the limitations of traditional OAB treatments and diagnostics.
• To explore the potential role of novel diagnostic techniques in identifying urinary tract microbes.

Main Methods:

• Review of existing scientific literature on OAB, urinary tract infections, and diagnostic technologies.
• Analysis of studies utilizing RNA sequencing and extended culture techniques for urine analysis.
• Examination of evidence connecting bacterial presence in urine to OAB symptomatology.

Main Results:

• Standard laboratory tests for bacterial presence in urine are frequently inadequate for OAB diagnosis.
• Advanced techniques like RNA sequencing demonstrate that urine harbors microorganisms.
• These identified microbes are increasingly implicated in the development or worsening of OAB.

Conclusions:

• Urinary tract microorganisms may be a significant factor in the etiology or exacerbation of overactive bladder.
• Rethinking OAB diagnosis and treatment may be necessary, considering the role of bacterial colonization.
• Further research into novel diagnostic and therapeutic approaches targeting urinary microbes is warranted.