Introduction: Fibromyalgia (FM) is a chronic pain disorder frequently accompanied by lower urinary tract symptoms (LUTS), yet the prevalence and clinical relevance of overactive bladder (OAB) in this population remain poorly defined. This study aimed to evaluate the prevalence of OAB among women with FM and to compare their clinical features with non-FM controls presenting with similar urinary complaints.
Methods: This cross-sectional controlled study included 232 women aged 18-65 years: 192 diagnosed with FM and 40 age- and symptom-matched controls. OAB was diagnosed based on International Continence Society (ICS) criteria using the Overactive Bladder Awareness Tool Version 8 (OAB-V8; cut-off ≥ 8) and a 3-day bladder diary. FM symptom burden was assessed using the Widespread Pain Index (WPI), Symptom Severity Scale (SSS), and General Symptom Score (GSS). Psychiatric comorbidities and irritable bowel syndrome (IBS) were also recorded.
Results: OAB was identified in 62.0% of FM patients and 28.6% of controls (p < 0.001). FM + OAB patients were significantly older and had longer disease duration than FM-OAB patients (p < 0.001). WPI, SSS, and GSS scores were significantly higher in FM + OAB compared to both FM-OAB and control+OAB groups (p < 0.001). Psychiatric comorbidities, IBS, and obesity were also more frequent in FM + OAB. Moderate correlations were observed between OAB and FM symptom severity (ρ = 0.33-0.42, p < 0.01).
Conclusions: OAB is highly prevalent and clinically relevant among women with FM. Its presence is associated with greater symptom severity and comorbid burden, supporting the hypothesis that OAB in FM may represent a manifestation of central sensitization.
Keywords: central sensitization; fibromyalgia; lower urinary tract symptoms; overactive bladder; women's health.
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