Rheumatoid Arthritis May Be Related To Lower Urinary Tract Symptoms (LUTS)

Patients with systemic lupus erythematosus (SLE), Sjogren's syndrome (SS), and Graves' disease are reported to be associated with an increased severity of LUTS compared with control populations. Peeler's recent report that in a survey of 222 patients with interstitial cystitis, RA was the second most common IC-associated disease, occurring in more than 13% of his patients (Scand J Urol Nephrol 37:60-63, 2003), stimulated Lee and colleagues to look for a relationship between RA and LUTS.


Urinary symptoms, including IC-like symptoms, were investigated in a cohort of patients with RA. Results were compared with a group of age-matched controls. Patients with urinary tract infection and those on medications that could induce oral or ocular dryness were excluded from the analysis. One hundred eighty-nine patients were compared with 679 controls. AUA symptom scores and percentage of individuals reporting severe LUTS (AUA score >20) were similar in both groups. Likewise, there was no significant difference in patients reporting IC-like symptoms as per the O'Leary Sant Interstitial Cystitis Symptom Index. Multivariate regression analysis did reveal that SS was significantly correlated with severe LUTS as per the AUA Symptom Index. There was a trend toward a higher score on the O'Leary Sant Symptom Index in patients with SS, but this did not reach statistical significance.


The authors conclude that RA does not by itself predispose to increased severity of LUTS. Patients with secondary SS do have more severe LUTS. This is an excellent study. One wonders whether some symptoms suggestive of PBS/IC may have been masked by treatment for RA that was ongoing in these patients.


By Philip M. Hanno MD, MPH


Reference:

Scand J Rheumatol 35:96-101, 2006

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