Association of uterine leiomyoma and overactive bladder syndrome

Koch, Marianne; Rauchenwald, Tina; Kivaranovic, Danijel; Schwab, S.; Umek, Wolfgang; Koelbl, Heinz; Rauchenwald, Michael; Helmy, S.

doi:10.1002/ijgo.12545

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…The location and size of leiomyomas also has been associated with worse lower urinary tract symp-toms, although this review demonstrates that this relationship is not well studied. One study found a significant association between anterior or fundal leiomyoma and overactive bladder symptoms, 6 and others have suggested that anterior-dominant leiomyomas and leiomyomas larger than 5 cm are associated with more severe symptoms. 7,59 However, there were insufficient data from this review to select interventions for pelvic floor symptom improvement or prevention based on size and location of leiomyomas.…”

Section: Discussionmentioning

confidence: 98%

“…3 Pelvic floor symptoms are common in women with uterine leiomyomas; 56-64% of patients report urinary frequency, 35-59% report urinary incontinence (UI), and 40% report bowel symptoms such a fecal urgency and straining to have a bowel movement. [4][5][6][7] The precise relationship between leiomyo-mas and pelvic floor dysfunction is unclear. The close anatomic relationship of the uterus to the bladder and rectum as well as larger leiomyoma size resulting in mass effect on adjacent organs are postulated links between leiomyomas and pelvic floor dysfunction.…”

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confidence: 99%

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Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas

Gupta

Balk

Lenger

et al. 2023

Obstetrics &Amp; Gynecology

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OBJECTIVE: To conduct a systematic review to evaluate the effect of procedural interventions for leiomyomas on pelvic floor symptoms. DATA SOURCES: PubMed, EMBASE, and ClinicalTrials.gov were searched from inception to January 12, 2023, searching for leiomyoma procedures and pelvic floor disorders and symptoms, restricted to primary study designs in humans. METHODS OF STUDY SELECTION: Double independent screening for studies of any study design in all languages that reported pelvic floor symptoms before and after surgical (hysterectomy, myomectomy, radiofrequency volumetric thermal ablation) or radiologic (uterine artery embolization, magnetic resonance-guided focused ultrasonography, high-intensity focused ultrasonography) procedures for management of uterine leiomyomas. Data were extracted, with risk-of-bias assessment and review by a second researcher. Random effects model meta-analyses were conducted, as feasible. TABULATION, INTEGRATION, AND RESULTS: Six randomized controlled trials, one nonrandomized comparative study, and 25 single-group studies met criteria. The overall quality of the studies was moderate. Only six studies, reporting various outcomes, directly compared two procedures for leiomyomas. Across studies, leiomyoma procedures were associated with decreased symptom distress per the UDI-6 (Urinary Distress Inventory, Short Form) (summary mean change −18.7, 95% CI −25.9 to −11.5; six studies) and improved quality of life per the IIQ-7 (Incontinence Impact Questionnaire, Short Form) (summary mean change −10.7, 95% CI −15.8 to −5.6; six studies). There was a wide range of resolution of urinary symptoms after procedural interventions (7.6–100%), and this varied over time. Urinary symptoms improved in 19.0–87.5% of patients, and the definitions for improvement varied between studies. Bowel symptoms were inconsistently reported in the literature. CONCLUSION: Urinary symptoms improved after procedural interventions for uterine leiomyomas, although there is high heterogeneity among studies and few data on long-term outcomes or comparing different procedures. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42021272678.

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas

Gupta

Balk

Lenger

et al. 2023

Obstetrics &Amp; Gynecology

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“…[87][88][89] Pathology and illness LUTS onset in middle-aged and elderly women involves pregnancy, delivery, pelvic organ prolapse, menopause, estrogen deficiency, neurologic disorders, and aging. 1,5,6,75 Causative diseases with a high incidence of storage symptoms include urinary tract infection, OAB, stress urinary incontinence, pelvic organ prolapse, and interstitial cystitis, 1,[93][94][95][96][97][98] whereas causes of voiding symptoms and post-micturition symptoms include organic disease of the lower urinary tract such as bladder neck obstruction, bladder calculus, and urethral stricture, as well as age-related underactive bladder, disorders of the central nervous system, neurogenic bladder (seen following surgery for uterine cancer and rectal cancer), a history of urinary incontinence surgery, and cases associated with pelvic organ prolapse. 1,9,[99][100][101][102][103][104] Diagnosis is difficult in instances that cannot be inferred based on the patient's medical history, and urodynamic measurement is performed as needed in such cases.…”

Section: The Epidemiology Of Flutsmentioning

confidence: 99%

Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition)

Takahashi¹,

Takei²,

Asakura³

et al. 2021

Int J of Urology

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The present article is an abridged English translation of the Japanese Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition), published in September 2019. These guidelines consist of a total of 212 pages and are unique worldwide in that they cover female lower urinary tract symptoms other than urinary incontinence. They contain two algorithms for "primary treatment" and "specialized treatment," respectively. These guidelines, consisting of six chapters, address a total of 26 clinical questions including: (i) treatment algorithms; (ii) what are female lower urinary tract symptoms?; (iii) epidemiology and quality of life; (iv) pathology and illness; (v) diagnosis; and (vi) treatment. When the patient's symptoms mainly involve voiding and post-micturition symptoms, specialized treatment should be considered. In the event of voiding symptoms concurrent with storage symptoms, residual urine should be measured; if the residual urine volume is <100 mL, then diagnosis and treatment for storage symptoms is prioritized, and if the volume is ≥100 mL, then specialized treatment should be considered. When storage symptoms are the primary condition, then the patient is subject to the primary treatment algorithm. Specialized treatment for refractory overactive bladder includes botulinum toxin injection and sacral nerve stimulation. For stress urinary incontinence, surgical treatment is indicated, such as urethral slings. The two causes of voiding symptoms and post-micturition symptoms are lower urinary tract obstruction and detrusor underactivity (underactive bladder). Mechanical lower urinary tract obstruction, such as pelvic organ prolapse, is expected to improve with surgery.

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“…In addition, there seems to be a significant association between anterior and/or fundal leiomyoma and OAB. For this reason, the presence of uterine leiomyoma should be taken into account in women affected by overactive bladder [18][19][20][21].…”

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confidence: 99%

A comparison of sacral neuromodulation vs. transvaginal electrical stimulation for the treatment of refractory overactive bladder: the impact on quality of life, body image, sexual function, and emotional well-being

Rosa

Platania²,

Ciebiera

et al. 2019

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Overactive bladder syndrome (OAB) is defined by the presence of urinary urgency, with or without urge incontinence, usually accompanied by an increase in urinary frequency and nocturia in the absence of urinary tract infections (UTI) or other diseases. The overall prevalence of OAB symptoms in the female population is reported to be 16.6% and increases with advancing age and menopause. The aetiology of OAB is not fully understood and is likely to affect a heterogeneous population of patients due to changes to their central and peripheral nervous systems. Although OAB is frequently associated with female sexual dysfunction (FSD), its real impact on sexual function in women has been evaluated only in a few studies. The first line of treatment for OAB includes behavioural modification and physical therapy, either as monotherapies or in combination. Many patients who have not had success in managing their symptoms with more conservative therapies may decide to resort to third-line treatments for refractory OAB. These treatments include neuromodulation therapies, particularly transvaginal electrical stimulation (TES) and sacral neuromodulation (SN). The aim of this short commentary is to provide an overview of the effectiveness of these treatments and of their impact on quality of life, body image, sexual function, and emotional well-being.

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Association of uterine leiomyoma and overactive bladder syndrome

Abstract: The study found a significant association between anterior and/or fundal leiomyoma and overactive bladder syndrome. The presence of uterine leiomyoma should be ruled out during the evaluation of overactive bladder.

Cited by 5 publications

References 18 publications

Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas

Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas

Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition)

A comparison of sacral neuromodulation vs. transvaginal electrical stimulation for the treatment of refractory overactive bladder: the impact on quality of life, body image, sexual function, and emotional well-being

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