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Overactive bladder and autonomic dysfunction: Lower urinary tract symptoms in females with postural tachycardia syndrome
Author(s) -
Kaufman Melissa R.,
ChangKit Laura,
Raj Satish R.,
Black Bonnie K.,
Milam Douglas F.,
Reynolds W. Stuart,
Biaggioni Italo,
Robertson David,
Dmochowski Roger R.
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22971
Subject(s) - medicine , nocturia , overactive bladder , lower urinary tract symptoms , urinary urgency , urinary system , quality of life (healthcare) , population , heart rate , tachycardia , physical therapy , blood pressure , prostate , alternative medicine , nursing , environmental health , pathology , cancer
Aims Postural Tachycardia Syndrome (POTS) represents an autonomic disorder predominantly affecting females between 15 and 50 years of age. POTS is a chronic disorder (>6 months) characterized by an excessive heart rate increment on standing (>30 beats/min) in the presence of characteristic symptoms of cerebral hypoperfusion or sympathetic activation. Patients have clinically been noted to describe lower urinary tract symptoms (LUTS), although urologic symptoms have not been methodically assessed in the POTS population. Herein, we present data from a pilot study designed to identify and quantitate overactive bladder (OAB) in patients diagnosed with POTS. Methods Patients admitted to the Vanderbilt Autonomic Dysfunction Center between June 2009 and October 2010 for evaluation for the potential diagnosis of POTS completed a validated, standardized questionnaire for OAB (OAB‐q) at presentation. Symptom score and subscale analyses were conducted. Subscale health related quality of life (HRQL) scores were transformed into a 0–100 scale, with higher scores reflecting superior HRQL. Data are presented as mean ± SD. Results Thirty‐two females presented for evaluation of symptoms consistent with POTS. Twenty‐nine women were subsequently diagnosed with POTS with 19 of these patients completing the OAB‐q questionnaire (65.5% response rate). Average age was 33.5 ± 8.3 years. Symptom severity transformed score was 26.0 ± 16.4, with 13 of 19 patients (68.4%) meeting clinical criteria for diagnosis of probable clinically significant OAB. Nocturia was the most bothersome symptom, followed by increased daytime frequency and urgency. Conclusions This pilot study describes bothersome lower urinary tract dysfunction in patients presenting with POTS as assessed by patient‐reported questionnaire data. Nocturia demonstrated the greatest negative impact on health‐related quality of life (HRQL), while social interaction was the least affected HRQL domain. In patients with dysautonomia, this data provides a critical baseline for mechanistic insight into both disease‐specific and global pathophysiology of nocturia and OAB. Neurourol. Urodynam. 36:610–613, 2017 . © 2016 Wiley Periodicals, Inc.