Lower urinary tract symptoms common among women with endometriosis

Women with endometriosis are more likely to develop various lower urinary tract symptoms (LUTSs), including difficulty passing urine, having to urinate again within minutes of urinating, or still feeling full after urination, a study has found.

The analysis used data from the Women’s Health Study: from Adolescence to Adulthood and included 1,161 women, among whom 520 had surgically confirmed endometriosis (mean age 20.8 years, mean body mass index 23.2 kg/m²).

All participants completed standardized questionnaires to assess the prevalence of LUTSs, including stress incontinence, urgency and frequency, straining with urination, incomplete bladder emptying, haematuria, dysuria, and bladder pain.

Most participants in both groups were White, non-Hispanic, and nulliparous. More women in the endometriosis vs control group reported acyclic pelvic pain (65 percent vs 13 percent) and any LUTS (56 percent vs 34 percent).

Multivariable regression analysis confirmed that endometriosis was associated with a greater likelihood of the following symptoms: difficulty passing urine (7.9 percent vs 2 percent; adjusted odds ratio [aOR], 4.31, 95 percent confidence interval [CI], 2.07–8.95), still feeling full after urination (18.8 percent vs 4.7 percent; aOR, 4.67, 95 percent CI, 2.88–7.56), having to urinate again within minutes of urinating (33.1 percent vs 17.0 percent; aOR, 2.49, 95 percent CI, 1.81–3.43), dysuria (11.7 percent vs 4.9 percent; aOR, 2.38, 95 percent CI, 1.40–4.02), and pain when the bladder is full (23.0 percent vs 4.9 percent; aOR, 6.04, 95 percent CI, 3.74–9.76).

Of note, the odds of LUTS did not differ by disease stage (revised American Society for Reproductive Medicine stage I/II vs III/IV) or duration of endometriosis-associated symptoms.

The findings highlight a need for LUTSs to be concurrently addressed during the initial diagnosis and subsequent management of endometriosis.