Chronic Urinary Infection in Overactive Bladder Syndrome: A Prospective, Blinded Case Control Study.

Area of Science:

• Urology
• Microbiology
• Infectious Diseases

Background:

• Overactive bladder (OAB) is a condition affecting many women, often without clear signs of infection.
• Conventional urine cultures may fail to detect underlying subclinical infections contributing to OAB symptoms.

Purpose of the Study:

• To investigate alternative indicators of subclinical infection in women with overactive bladder (OAB) symptoms.
• To compare the efficacy of routine versus enhanced urine cultures in detecting bacterial presence in OAB patients.

Main Methods:

• A prospective, blinded case-control study involving 147 participants (73 OAB patients, 74 controls).
• Urine samples were analyzed for pyuria, subjected to routine and enhanced microbiological cultures, and assessed for 10 biomarkers via ELISA.

Main Results:

• Enhanced urine cultures detected bacteria in 23.2% of OAB patients, compared to only 4% with routine cultures.
• Enhanced cultures identified bacteria in 10.8% of controls, while routine cultures yielded no positive results.
• No significant differences in pyuria or measured biomarkers (cytokines, chemokines, prostaglandins) were found between groups.

Conclusions:

• OAB patients frequently exhibit significant bacterial growth on enhanced urine cultures, indicative of subclinical infections.
• Routine urine cultures often miss these subclinical infections, highlighting their limitations in OAB diagnosis.
• Enhanced urine culture techniques are recommended for routine use in the effective diagnosis and management of overactive bladder.