Tzu Chi Medical Journal

REVIEW ARTICLE
Year
: 2021  |  Volume : 33  |  Issue : 1  |  Page : 13--21

Recurrent urinary tract infection in women and overactive bladder – Is there a relationship?


Qian-Sheng Ke, Cheng-Ling Lee, Hann-Chorng Kuo 
 Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan

Correspondence Address:
Dr. Hann-Chorng Kuo
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 707, Section 3, Chung-Yang Road, Hualien
Taiwan

Overactive bladder (OAB) in women has similar symptomatology with other common urologic diseases such as recurrent urinary tract infection (UTI). Recent evidence showed that chronic low-grade bacterial bladder colonization might exacerbate OAB symptoms and could be the etiology of recurrent UTI. The high prevalence of lower urinary tract dysfunction is associated with OAB. Women with urgency urinary incontinence refractory to antimuscarinic therapy had more bacteria and a more diverse urinary microbiome. The bacterial reside in the superficial urothelial cells to form intracellular bacterial community and outbreak when the host innate immunity is low. Women with recurrent UTI are found to have highly prevalent voiding dysfunction and detrusor overactivity. These functional abnormalities will further damage the urothelial barrier integrity and create vulnerable to uropathogen invasion. The defective urinary microbiota is less common in women with recurrent UTI, suggesting that the normal flora in the urine might inhibit uropathogen growth and invasion. The defective urothelial barrier function, deficient basal proliferation, and deficient maturation might be owing to chronic suburothelial inflammation, resulting in activation of sensory nerves (causing OAB) and failure elimination of intracellular bacterial communities (causing recurrent UTI). Precision diagnosis and multidisciplinary treatment of the underlying pathophysiology of OAB and recurrent UTI is necessary.


How to cite this article:
Ke QS, Lee CL, Kuo HC. Recurrent urinary tract infection in women and overactive bladder – Is there a relationship?.Tzu Chi Med J 2021;33:13-21


How to cite this URL:
Ke QS, Lee CL, Kuo HC. Recurrent urinary tract infection in women and overactive bladder – Is there a relationship?. Tzu Chi Med J [serial online] 2021 [cited 2021 Jan 22 ];33:13-21
Available from: https://www.tcmjmed.com/article.asp?issn=1016-3190;year=2021;volume=33;issue=1;spage=13;epage=21;aulast=Ke;type=0