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. 2024 Jul-Aug;38(4):2031-2040.
doi: 10.21873/invivo.13661.

Relationship Between Overactive Bladder and Bone Fracture Risk in Female Patients

Shintaro Mori  1 , Tomohiro Matsuo  2 , Hiroyuki Honda  1 , Kyohei Araki  1 , Kensuke Mitsunari  1 , Kojiro Ohba  1 , Ryoichi Imamura  1
Affiliations

Relationship Between Overactive Bladder and Bone Fracture Risk in Female Patients

Shintaro Mori et al. In Vivo. 2024 Jul-Aug.

Abstract

Background/aim: Overactive bladder (OAB) has recently been recognized as an independent risk factor for falls and fractures. This study aimed to predict fracture risk in female patients with OAB symptoms.

Patients and methods: We assessed and compared the fracture risk in newly diagnosed female patients with OAB to those without OAB using the Fracture Risk Assessment Tool (FRAX), and investigated the relationship between fracture risk and OAB severity.

Results: The present single-center, cross-sectional study included 177 female participants (79 with OAB, 98 without OAB). The OAB group was older (p=0.033) and shorter (p=0.010) compared to the non-OAB group. Compared to the non-OAB group, the OAB group had more patients with hypertension (p<0.001) and diabetes mellitus (p=0.011), as well as higher risks for major fractures (non-OAB group: 15.2±13.2%; OAB group: 23.6±14.1%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%; OAB group: 10.6±10.0%; p=0.007). In addition, those with moderate/severe OAB had the most significantly elevated risks for both major fractures (non-OAB group: 15.2±13.2%, mild-OAB: 17.6±12.5%, moderate/sever-OAB: 26.4±14.0%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%, mild-OAB: 6.5±7.6%, moderate/sever-OAB: 12.5±10.4%; p<0.001). Among the OAB symptoms, nocturia had the strongest correlation with fracture risk (major fracture, ρ=0.534; hip fracture, ρ=0.449; all p<0.001).

Conclusion: Patients with severe OAB, and particularly severe nocturia, should be closely monitored with timely and aggressive symptom management; however, an interventional study incorporating the management of OAB symptoms is required to confirm whether the proactive management of OAB symptoms reduces the risk of fractures in older females.

Keywords: Overactive bladder; aging; bone fracture; bone fracture risk assessment; female.

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Conflict of interest statement

The Authors declare no conflicts of interest in relation to this study.

Figures

Figure 1
Figure 1. Flow chart of patient selection. OAB: Overactive bladder; LUTS: lower urinary tract symptom.
Figure 2
Figure 2. The relationship between overactive bladder (OAB) and fracture risk. A) Major fracture risk; B) hip fracture risk. The risk of major fracture in the OAB group was higher than that in the non-OAB group (non-OAB group: 15.2±13.2%; OAB group: 23.6±14.1%; p<0.001). The risk of hip fracture in the OAB group was higher than that in the non-OAB group (non-OAB group: 6.3±11.0%; OAB group: 10.6±10.0%; p=0.007).
Figure 3
Figure 3. The relationship between overactive bladder (OAB) severity and fracture risk. A) Major fracture risk; B) hip fracture risk. The risk of major fracture in moderate/severe OAB group was highest in all groups (non-OAB group, 15.2±13.2%; mild OAB group, 17.6±12.5%; moderate/severe OAB group, 26.4±14.0%; p<0.001). The risk of hip fracture in moderate/severe OAB group was highest in all groups (non-OAB group, 6.3±11.0%; mild OAB group, 6.5±7.6%; moderate/severe OAB group, 12.5±10.4%; p<0.001).
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