Key result
Overactive bladder and anxiety appear to have a bidirectional association and shared pathophysiological pathways, though longitudinal cohort studies are limited.
Why the study?
The combination of overactive bladder and anxiety presents a causality dilemma, motivating a review to address available insights into their bidirectional association.
This review highlights a bidirectional temporal relationship between overactive bladder and anxiety, suggesting that psychosocial factors should be routinely assessed in OAB patients.
OBJECTIVE: Although available diagnostic criteria are intelligible, combination of OAB and anxiety in the same patient presents a perfect example of medical causality dilemma, commonly stated as the question: "which came first: the chicken or the egg?". The aim of this review article is to address available insights in bidirectional association between OAB and anxiety. METHODS: In this review article, we included different types of studies whose results are presented as relative risk (RR) or odds ratio (OR) with a 95% accuracy. A literature search was conducted with the use of the PubMed and EMBASE electronic databases focusing on identifying articles published in English between 1990 and 2020. RESULTS: The electronic searches, after duplicate records removal, provided a total of 126 citations. Of these, 107 were excluded after title/abstract screening (not relevant to the review). We examined the full text of 19 publications remaining to summarize possible mechanisms between OAB and anxiety. According to examined literature, our result synthesis provides insight in epidemiology, pathophysiology, diagnostic and therapeutic approach of both conditions. CONCLUSION: Temporal relationship between OAB and anxiety is not very well documented because available longitudinal cohort studies are limited. The limitation of the published literature is that most were population-based symptom studies demonstrating high risk of bias. Although data from analysed studies suggest that anxiety and OAB and anxiety might be casually related, studies provided on clinical population are warranted. In addition to the traditional urologic factors, we recommend that psychosocial factors such as anxiety should be assessed routinely in patients with OAB.
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Grizelj et al. (2021) conducted a review in Overactive bladder and anxiety. Overactive bladder and anxiety appear to have a bidirectional association and shared pathophysiological pathways, though longitudinal cohort studies are limited.
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