Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr;36(4):741-748.
doi: 10.1007/s00192-024-06018-5. Epub 2024 Dec 30.

A Systematic Review of the Prevalence of Overactive Bladder in Women with Non-Urinary Tract Endometriosis and the Effect of Endometriosis Surgery on Symptoms of Overactive Bladder

Francis G Muriithi  1   2 , Monika Vij  3   4 , Siddhartha Mukherjee  3 , Simon Emery  3   4
Affiliations

A Systematic Review of the Prevalence of Overactive Bladder in Women with Non-Urinary Tract Endometriosis and the Effect of Endometriosis Surgery on Symptoms of Overactive Bladder

Francis G Muriithi et al. Int Urogynecol J. 2025 Apr.

Abstract

Introduction and hypothesis: Overactive bladder (OAB) is characterised by urinary urgency, with or without incontinence, often accompanied by daytime frequency and nocturia, in the absence of urinary tract infection or other identifiable causes. Population studies estimate the prevalence of OAB at 12.8% (EPIC study), increasing with age, reaching up to 43% after age 40. Endometriosis affects about 10% of women of reproductive age. Both OAB and endometriosis are chronic and negatively impact women's quality of life. They appear to share a common pathophysiology related to central sensitisation. We hypothesised that OAB and endometriosis might co-exist, and surgical excision of endometriosis could alleviate OAB symptoms. We aimed to assess the prevalence of OAB in patients with endometriosis and examine the effect of endometriosis surgery on OAB symptoms.

Methods: A systematic search of MEDLINE, PubMed, Embase, and CINAHL-Plus identified studies reporting on endometriosis and OAB or overlapping conditions such as interstitial cystitis. Studies on bladder or ureteric endometriosis were excluded.

Results: Six studies (772 participants) were included. The prevalence of OAB in endometriosis patients ranged from 9.4% (Brazil) to 32% (France). OAB diagnosis varied, with tools such as International Consultation of Incontinence Modular Questionnaire on Female Lower Urinary Tract Symptoms, Core Lower Urinary Tract Symptom Score, Bristol Female Lower Urinary Tract Symptoms, and urodynamics. Surgical outcomes were inconsistent, with no improvement in three studies, equivocal in one, and worsened in another.

Conclusion: Overactive bladder and non-urinary tract endometriosis may co-occur in 20.5% of patients, with surgery showing variable effects on OAB symptoms. Further standardised global research is warranted to fill in evidence gaps such as whether pre-operative desensitisation could improve surgical and quality-of-life outcomes.

Keywords: Central sensitization syndrome; Endometriosis; Outcome; Overactive bladder; Prevalence.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics Statement: Ethical approval was not sought as this study is a systematic review of published literature and did not include individual patient information. Conflicts of Interest: The authors have no conflicts of interest to declare.

Similar articles

See all similar articles

References

    1. Peinado-Molina RA, Hernández-Martínez A, Martínez-Vázquez S, Rodríguez-Almagro J, Martínez-Galiano JM. Pelvic floor dysfunction: prevalence and associated factors. BMC Public Health. 2023;23(1):2005. https://doi.org/10.1186/s12889-023-16901-3 . - DOI - PubMed
    1. O’Sullivan ED, Schofield SJ. Cognitive bias in clinical medicine. J R Coll Physicians Edinb. 2018;48(3):225–32. https://doi.org/10.4997/JRCPE.2018.306 . - DOI - PubMed
    1. Gabriel I, Vitonis AF, Missmer SA, Fadayomi A, DiVasta AD, Terry KL, et al. Association between endometriosis and lower urinary tract symptoms. Fertil Steril. 2022;117(4):822–30. https://doi.org/10.1016/j.fertnstert.2022.01.003 . - DOI - PubMed
    1. Nackeeran S, Ramasamy R. Endometriosis and lower urinary tract symptoms: association or causation? Fertil Steril. 2022;117(4):831. https://doi.org/10.1016/j.fertnstert.2022.01.021 . - DOI - PubMed
    1. Ackerman AL, Lai HH, Parameshwar PS, Eilber KS, Anger JT. Symptomatic overlap in overactive bladder and interstitial cystitis/bladder pain syndrome: development of a new algorithm. BJU Int. 2019;123(4):682–93. https://doi.org/10.1111/bju.14568 . - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources