Pelvic Inflammatory Disease is a Risk Factor for Overactive Bladder

Context Pelvic inflammatory disease (PID) is an ascending infection of the reproductive tract that can cause infertility and ectopic pregnancy. While reproductive effects are well known, urinary impacts remain underexplored. Overactive bladder (OAB)—characterized by urgency, frequency, and nocturia—may be associated with PID. Clarifying this relationship is important in primary care, where both conditions affect quality of life and are often underdiagnosed. This is a publication of the abstract and poster of this preliminary work that was presented at the 2025 TAFP Primary Care Summit. Objective To evaluate the association between PID and OAB symptoms among U.S. women. Design Retrospective cohort study using secondary analysis of the National Health and Nutrition Examination Survey (NHANES) 2017–2020. Setting Nationally representative community-based survey. Patients or Other Participants Women ≥18 years who completed both the Reproductive Health and Kidney Conditions questionnaires in NHANES. Participants were classified by self-reported PID history and OAB symptoms. Main and Secondary Outcome Measures Primary outcome: prevalence of OAB (urgency, leakage, nocturia). Secondary outcomes: leakage characteristics, daily activity impact, and nocturnal urination frequency. Results The results and findings of this study are preliminary. Weighted analysis represented ~41 million U.S. women. Those with PID were more likely to report leakage during physical activity (p=0.002), leakage before reaching the toilet (p=0.004), bothersome leakage (p=0.014), activity limitation due to leakage (p=0.003), and increased nocturnal urination (p=0.002). Logistic regression showed PID remained significantly associated with OAB after adjusting for age and race. Conclusions PID is significantly associated with OAB symptoms in U.S. women. While causality cannot be determined, findings support targeted urinary symptom screening in patients with prior PID. Further studies should investigate underlying mechanisms and potential preventive strategies in primary care settings. In addition, as mentioned, this is preliminary work that was presented at the 2025 TAFP Primary Care Summit.