A prospective observational study of urinary cytokines and inflammatory response in patients with Overactive Bladder Syndrome

BackgroundContemporary studies have discredited the methods used to exclude urinary tract infection (UTI) when treating overactive bladder (OAB). Thus we must revisit the OAB phenotype to check that UTI has not been overlooked.AimsTo examine the differences in urinary cytokines IL6 and lactoferrin in OAB patients compared to controls, with references to microscopy of urine and enhanced quantitative urine culture.MethodsA blinded, prospective cohort study with normal controls using six repeated measures, achieved two-monthly, over 12 months.ResultsThe differences between patients and controls in urine IL6 (F=49.0, p<.001) and lactoferrin (F=228.5, p<.001) were significant and of a magnitude to have clinical implications. These differences were for lactoferrin correlated to symptoms (9.3, p=.003); for both to pyuria (IL6 F=66.2, p<.001, Lactoferrin F=73.9, p<.001); and for IL6 microbial abundance (F=5.1, p=.024). The pathological markers had been missed by urinary dipsticks and routine MSU culture.ConclusionThe OAB phenotype may encompass patients with UTI that is being overlooked because of the failure of standard screening methods.

Automated summary

The study revealed significant differences in urine IL6 and lactoferrin between OAB patients and controls, with clinical implications related to symptoms and pyuria. These pathological markers were missed by standard screening methods, indicating the need for reevaluation of UTI in OAB patients.