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Purpose: We characterized continence, satisfaction and adverse events in women at least 5 years after Burch urethropexy or fascial sling with longitudinal followup of randomized clinical trial participants. Materials and Methods: Of 655 women who participated in a randomized surgical trial comparing the efficacy of the Burch and sling treatments 482 (73.6%) enrolled in this long-term observational study. Urinary continence status was assessed yearly for a minimum of 5 years postoperatively. Continence was defined as no urinary leakage on a 3-day voiding diary, and no self-reported stress incontinence symptoms and no stress incontinence surgical re-treatment. Results: Incontinent participants were more likely to enroll in the followup study than continent patients (85.5% vs 52.2%) regardless of surgical group (p <0.0001). Overall the continence rates were lower in the Burch urethropexy group than in the fascial sling group (p = 0.002). The continence rates at 5 years were 24.1% (95% CI 18.5 to 29.7) vs 30.8% (95% CI 24.7 to 36.9), respectively. Satisfaction at 5 years was related to continence status and was higher in women undergoing sling surgery (83% vs 73%, p = 0.04). Satisfaction decreased with time (p = 0.001) and remained higher in the sling group (p = 0.03). The 2 groups had similar adverse event rates (Burch 10% vs sling 9%) and similar numbers of participants with adverse events (Burch 23 vs sling 22). Conclusions: Continence rates in both groups decreased substantially during 5 years, yet most women reported satisfaction with their continence status. Satisfaction was higher in continent women and in those who underwent fascial sling surgery, despite the voiding dysfunction associated with this procedure. [ABSTRACT FROM AUTHOR]

Purpose: Interstitial cystitis/bladder pain syndrome is a chronic urological condition diagnosed in nearly 8 million females in the United States. Whether urinary microbiota play an etiological role remains controversial. Most studies assessed the microbiota of interstitial cystitis/bladder pain syndrome patients with voided or catheterized urine as a proxy for bladder urothelium; however, urine may not be a true reflection of the bladder microbiota. Bladder biopsy tissue may provide a more accurate, and thus more clinically relevant, picture of bladder microbiota., Materials and Methods: Bladder biopsy tissues were obtained from: (1) 30 females with interstitial cystitis/bladder pain syndrome (18-80 years old) via cystoscopically guided cold-cup biopsy following therapeutic bladder hydrodistention, and (2) 10 non-interstitial cystitis/bladder pain syndrome females undergoing pelvic organ prolapse repair. To detect bacteria, technical duplicates of each RNAlater-preserved biopsy were subjected to 16S rRNA gene sequencing. To visualize bacteria, paraformaldehyde-fixed, paraffin-embedded biopsies were subjected to a combined multiplexed fluorescence in situ hybridization and fluorescence immunohistochemistry assay and confocal microscopy., Results: Bacteria were detected by 16S rRNA gene sequencing in at least 1 technical duplicate of most biopsies. The most abundant genus was Staphylococcus , followed by Lactobacillus ; Escherichia was common but not abundant. There was no significant difference between interstitial cystitis/bladder pain syndrome patients and controls ( P > .05). Combined fluorescence in situ hybridization and immunohistochemistry reproducibly detected 16S rRNA in epithelial cells and shed cells in the urothelium and lesioned areas and capillary walls in the lamina propria of human bladder biopsy tissue., Conclusions: We conclude that urothelial and urinary microbiota are similar but not identical in adult females.

Purpose: We describe the item development and cognitive evaluation process used in creating the Prevention of Lower Urinary Tract Symptoms Bladder Health Instrument (PLUS-BHI)., Materials and Methods: Questions assessing bladder health were developed using reviews of published items, expert opinion, and focus groups' transcript review. Candidate items were tested through cognitive interviews with community-dwelling women and an online panel survey. Items were assessed for comprehension, language, and response categories and modified iteratively to create the PLUS-BHI., Results: Existing measures of bladder function (storage, emptying, sensation components) and bladder health impact required modification of time frame and response categories to capture a full range of bladder health. Of the women 167 (18-80 years old) completed individual interviews and 791 women (18-88 years) completed the online panel survey. The term "bladder health" was unfamiliar for most and was conceptualized primarily as absence of severe urinary symptoms, infection, or cancer. Coping mechanisms and self-management strategies were central to bladder health perceptions. The inclusion of prompts and response categories that captured infrequent symptoms increased endorsement of symptoms across bladder function components., Conclusions: Bladder health measurement is challenged by a lack of awareness of normal function, use of self-management strategies to mitigate impact on activities, and a common tendency to overlook infrequent lower urinary tract symptoms. The PLUS-BHI is designed to characterize the full spectrum of bladder health in women and will be validated for research use.

Purpose: We examined the association of race/ethnicity with urinary incontinence subtypes and overactive bladder, and associated bother in older men., Materials and Methods: This cross-sectional analysis used data from the Multi-Ethnic Study of Atherosclerosis, an observational cohort of 4 racial/ethnic groups. At the sixth followup examination (age 60 to 98 years, 2015 to 2016) urinary symptoms were ascertained with the International Consultation on Incontinence Questionnaire. Prevalence ratios of urinary incontinence subtypes and overactive bladder without incontinence by race/ethnicity were calculated while adjusting for demographics, comorbidities and medications. Degree of bother was based on scale of 0 (none) to 10 (most) with bother presence defined as a score of 3 or greater., Results: Among 1,536 men 94% completed the questionnaire. Among completers, race/ethnicity was 40.7% nonHispanic White, 14.3% Chinese, 23.0% nonHispanic Black and 22.1% Hispanic. Urinary incontinence was reported by 11.1% and urgency urinary incontinence accounted for 78.0% of all urinary incontinence. The highest prevalence of urgency urinary incontinence was noted among nonHispanic Black men (13.0%) followed by Hispanic (11.3%), nonHispanic White (6.8%) and Chinese (2.9%) men. NonHispanic Black men showed a higher prevalence of any urinary incontinence (PR 1.62, 95% CI 1.06-2.47) and urgency urinary incontinence (1.63, 95% CI 1.01-2.61) compared to nonHispanic White men after adjustments for covariates. No significant association was noted with other urinary incontinence subtypes by race/ethnicity after adjustment for covariates. More than 70% of urinary incontinence was associated with bother for all racial/ethnic groups., Conclusions: Urinary incontinence prevalence differs by race/ethnicity but most urinary incontinence is associated with bother regardless of race/ethnicity.

Purpose: To determine the best predictor of the mid urethral sling outcome we calculated the AUC of ROC curves of preoperative parameters, including Valsalva leak point pressure, maximum urethral closure pressure, urinary NTx (N-telopeptide of crosslinked type I collagen) and plasma vitamin D values (D2, D3 and D2 plus D3)., Materials and Methods: This was an ancillary study of TOMUS (Trial of Mid-urethral Slings) and the ValUE (Value of Urodynamics Evaluation) trial in which subjects underwent mid urethral sling surgery for stress urinary incontinence. Valsalva leak point pressure and maximum urethral closure pressure were measured in 427 subjects, whereas NTx, vitamin D2, vitamin D3 and vitamin D2 plus D3 levels were obtained from 150, 116, 115 and 116 subjects respectively. Outcome success was defined using identical outcome (subjective and objective) variables for all subjects. ROC curves with corresponding AUC values were compared., Results: TOMUS and ValUE subjects were significantly different in age, body mass index, UDI (Urogenital Distress Inventory) scores. TOMUS subjects had a lower surgical success rate compared to ValUE subjects (66.3% vs 76.0%, p = 0.03). The AUC values of Valsalva leak point pressure, maximum urethral closure pressure, NTx, and vitamins D2, D3 and D2 plus D3 were 0.542, 0.561, 0.702, 0.627, 0.645 and 0.640, respectively. The AUC of NTx was significantly higher than the AUCs of Valsalva leak point pressure and maximum urethral closure pressure (p = 0.02 and 0.03, respectively)., Conclusions: Urinary NTx was the best predictor of the mid urethral sling outcome. This test is not only noninvasive, it is also modifiable. Finding ideal modifiable risk factors prior to mid urethral sling surgery should be subject to future investigations., (Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

Purpose: Despite preoperative screening and treatment for urinary tract infections, a postoperative urinary tract infection develops in approximately 1 in 5 urogynecologic patients. In this study we assess the proportion of urogynecologic patients with a positive day of surgery urine culture, the clinical consequences of a positive day of surgery culture and differences in postoperative urinary tract infection risks based on day of surgery culture., Materials and Methods: After institutional review board approval, patients undergoing urogynecologic surgery at Loyola University Medical Center were recruited for the study. Catheterized urine samples were collected in the operating room before intravenous antibiotic administration. Clinical cultures were considered positive if 1,000 colonies per ml or more bacteria were found on routine culture. For analysis we matched each woman with a positive culture with 2 women with negative culture by age within 10 years and within surgical groups (ie prolapse and/or incontinence). Data were analyzed using SPSS® version 19., Results: Nearly a tenth (9.5%) of participants had positive day of surgery cultures. The clinical and demographic characteristics were similar in women with negative vs positive day of surgery cultures. However, women with positive day of surgery cultures were more likely to experience a postoperative urinary tract infection despite standard perioperative antibiotic administration (29.6% vs 5.6%, p = 0.005, odds ratio 7.2). Regardless of day of surgery culture status no participant experienced postoperative systemic urinary complications., Conclusions: Nearly a tenth of urogynecologic patients had positive day of surgery cultures. Patients with a positive day of surgery culture had an increased risk (29.6%) of postoperative urinary tract infection within 6 weeks of surgery. These findings highlight an opportunity to identify and treat patients with positive day of surgery cultures and reduce the incidence of postoperative urinary tract infections., (Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

Purpose: We examined preoperative and postoperative patient related factors associated with continence status up to 7 years after surgery for stress urinary incontinence., Materials and Methods: Women randomized to Burch colposuspension or fascial sling surgery and assessed for the primary outcome of urinary continence 2 years after surgery were eligible to enroll in a prospective observational study. Survival analysis was used to investigate baseline and postoperative factors in the subsequent risk of stress urinary incontinence, defined as self-report of stress urinary incontinence symptoms, incontinence episodes on a 3-day diary or surgical re-treatment., Results: Of the women who participated in the randomized trial 74% (482 of 655) were enrolled in the followup study. Urinary continence rates decreased during a period of 2 to 7 years postoperatively from 42% to 13% in the Burch group and from 52% to 27% in the sling group, respectively. Among the baseline factors included in the first multivariable model age (p = 0.03), prior stress urinary incontinence surgery (p = 0.02), menopausal status (0.005), urge index (0.006), assigned surgery (p = 0.01) and recruiting site (p = 0.02) were independently associated with increased risk of incontinence. In the final multivariable model including baseline and postoperative factors, Burch surgery (p = 0.01), baseline variables of prior urinary incontinence surgery (p = 0.04), menopausal status (p = 0.03) and postoperative urge index (p <0.001) were each significantly associated with a greater risk of recurrent urinary incontinence., Conclusions: Preoperative and postoperative urgency incontinence symptoms, Burch urethropexy, prior stress urinary incontinence surgery and menopausal status were negatively associated with long-term continence rates. More effective treatment of urgency urinary incontinence in patients who undergo stress urinary incontinence surgery may improve long-term overall continence status., (Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

Purpose: We compared the proportion of women with complex repetitive discharges on urethral sphincter electromyography during filling cystometry among women with and without urinary disorders., Materials and Methods: After receiving institutional review board approval we recruited community dwelling women without urinary symptoms and women who presented for urinary incontinence treatment. Participants completed the Pelvic Floor Distress Inventory. Women who responded affirmatively to an inventory item ("Do you have difficulty emptying your bladder?" or "Do you experience a feeling of incomplete bladder emptying?") were classified with voiding dysfunction. Women with post-void residual urine greater than 100 ml, active urinary tract infection, prolapse greater than stage II or neuromuscular disease were excluded from study. Participants underwent standardized multichannel urodynamics with continuous concentric needle electromyography of the urethral sphincter throughout filling cystometry., Results: In the 31 controls and 56 incontinent participants mean±SD age was 48±15 years and median vaginal parity was 1 (range 0 to 2). The urodynamic diagnosis in the incontinent group included urodynamic stress incontinence in 31 (56%), detrusor overactivity with incontinence in 17 (30%) and mixed urodynamic stress incontinence with detrusor overactivity in 8 (14%). Of the women 26 (32%) met voiding dysfunction criteria with 96% reporting a feeling of incomplete bladder emptying and 53% reporting difficult bladder emptying. Controls were significantly more likely to have complex repetitive discharges than incontinent women (9 of 30 vs 2 of 56, p<0.002)., Conclusions: Complex repetitive discharges occur in about a third of women without urinary symptoms., (Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

Purpose: We measured patient reported bother due to overactive bladder syndrome, patterns of physician consultation and prescription medication use for overactive bladder symptoms in adults in the United States., Materials and Methods: A survey sample was derived from a consumer panel of 600,000 American households developed to match the United States Census of 260,000 adults. The survey included the Overactive Bladder-Validated 8 awareness tool, which includes 8 questions that measure the degree of bother due to specific bladder symptoms. A score of 8 or greater denotes probable overactive bladder. Additional questions probed treatment patterns, health care consultation, overactive bladder diagnosis, treatment type and prescription treatment used. A nonrespondent telephone survey in 1,004 participants was done to evaluate differences between mail survey respondents and nonrespondents., Results: The response rate was 63% (162,906 respondents). Women represented 55.1% of the sample and 21.8% of respondents were 65 years old or older. Symptom bother, as determined by an Overactive Bladder-Validated 8 score of 8 or greater, was reported by 26.6% of the total sample, including 23.7% of men and 28.9% of women. The percent of men and women reporting bother increased with age. Of respondents with probable overactive bladder only 45.7% had discussed the symptoms with a medical provider, 22.5% had previously used prescription medication for overactive bladder, 13.5% had used overactive bladder medication in the last 12 months and 8.1% were currently on treatment., Conclusions: A substantial proportion of adults in the United States reported some degree of bother due to overactive bladder symptoms. The degree of bother was associated with age and gender. Overall less than half of patients with probable overactive bladder discussed the symptoms with a health care provider. A small proportion was prescribed medication and an even smaller proportion was currently on treatment.

Purpose: We compared 200 U intradetrusor botulinum toxin A vs placebo in women with refractory idiopathic urge incontinence., Materials and Methods: This institutional review board approved, multicenter registered trial randomized women with refractory urge incontinence, detrusor overactivity incontinence and 6 or greater urge incontinence episodes in 3 days to botulinum toxin A or placebo at a 2:1 ratio. Refractory was defined as inadequate symptom control after 2 or more attempts at pharmacotherapy and 1 or more other first line therapies for detrusor overactivity incontinence. The primary outcome measure was time to failure, as evidenced by a Patient Global Impression of Improvement score of 4 or greater at least 2 months after injection, or changes in treatment (initiation or increase) at any time after injection. Safety data, including increased post-void residual volume, defined as more than 200 ml irrespective of symptoms, was obtained at specified time points., Results: Approximately 60% of the women who received botulinum toxin A had a clinical response based on the Patient Global Impression of Improvement. The median duration of their responses was 373 days, significantly longer than the 62 days or less for placebo (p <0.0001). In the botulinum toxin A group increased post-void residual urine (12 of 28 women or 43%) and urinary tract infection in those with increased post-void residual urine (9 of 12 or 75%) exceeded expected ranges. Further injections were stopped after 43 patients were randomized, including 28 to botulinum toxin A and 15 to placebo., Conclusions: Local injection of 200 U botulinum toxin A was an effective and durable treatment for refractory overactive bladder. However, a transient post-void residual urine increase was experienced in 43% of patients. Botulinum toxin A for idiopathic overactive bladder is still under investigation.

Purpose: We determined racial differences in urinary incontinence prevalence using the 2001-2004 National Health and Nutrition Examination Survey., Materials and Methods: The National Health and Nutrition Examination Survey is a continuous survey of a representative sample of the noninstitutionalized United States population. Demographic, self-reported racial/ethnic data and responses to the urinary portion of the survey were available for 4,229 women older than 20 years. We classified women by urinary incontinence subtype, that is pure stress incontinence, pure urge incontinence or mixed incontinence. Logistic regression models were fitted to investigate racial differences by type of urinary incontinence., Results: The sample was racially and ethnically diverse with 58% white nonHispanic, 22% Mexican-American and 20% black nonHispanic. Women were divided into 3 age ranges of 20 to 39 years old (36.3%), 40 to 59 (28%), and 60 years old or older (35.7%). Of the 4,229 women in the analytical sample 49.6% (2,098) reported urinary incontinence symptoms. Of those reporting incontinence symptoms 49.8% reported pure stress incontinence, 34.3% mixed incontinence and 15.9% pure urge incontinence. The odds of pure stress incontinence in white and Mexican-American women were approximately 2.5 times higher than in black women (OR 2.79, CI 2.1-3.8 and OR 2.5, CI 1.9-3.4) after adjusting for age, parity, body mass index and activity level. In contrast, black and Mexican-American women were more likely to report pure urge incontinence compared to white women (OR 0.6, CI 0.43-0.8). The prevalence of mixed incontinence was not significantly different among race/ethnicity groups., Conclusions: Race/ethnicity differences exist in self-reported urinary incontinence. While self-reported urinary incontinence is prevalent in United States community dwelling women regardless of racial background, the odds of pure stress incontinence are at least 2.5-fold higher in white and Mexican-American women than in black women.

Purpose: Given increased evidence of sensory dysfunction in lower urinary tract pathology, we determined normative current perception threshold values in the lower urinary tract of asymptomatic women., Materials and Methods: After receiving institutional review board approval women without lower urinary tract symptoms underwent current perception threshold testing of the urethra and bladder using a Neurometer constant current stimulator. Current perception threshold values were determined at 3 frequencies, including 2,000 Hz (corresponding to A-beta fibers), 250 Hz (corresponding to A-delta fibers) and 5 Hz (corresponding to C fibers)., Results: A total of 48 women with a mean age of 38 years (range 23 to 67) underwent current perception threshold testing. Normative values were established for the urethra and bladder at 2,000, 250 and 5 Hz. Median urethral current perception thresholds at 2,000, 250 and 5 Hz were 1.2 (IQR 0.76-1.5), 0.45 (IQR 0.33-0.56) and 0.11 mA (IQR 0.07-0.24), respectively. Median bladder current perception thresholds at 2,000, 250 and 5 Hz were 4.1 (IQR 2.0-6.3), 2.3 (IQR 0.87-5.5) and 1.4 mA (IQR 0.22-2.9), respectively. Urethral and bladder current perception thresholds increased significantly with subject age at all 3 frequencies (p<0.0005). Prior pelvic surgery was associated with an increased bladder current perception threshold at all 3 frequencies (p<0.005) but not with the urethral current perception threshold., Conclusions: We report urethral and bladder current perception thresholds for a large sample of asymptomatic women. These reference values may help elucidate changes in afferent nerve function in women with lower urinary tract dysfunction.

Purpose: We determined if the bladder volume at which urodynamic stress incontinence is first detected is related to preoperative quality of life, urethral sphincter assessment or surgical outcome in women undergoing continence surgery., Materials and Methods: Charts of consecutive women who underwent a sling or Burch procedure were reviewed. Preoperative and postoperative assessment included the Incontinence Impact Questionnaire and Urogenital Distress Inventory. Urodynamic stress incontinence volume is the bladder volume at which urodynamic stress incontinence was first detected. Women were divided into 4 groups according to urodynamic stress incontinence volume, and compared with respect to maximum urethral closure pressure, Valsalva leak point pressure, Incontinence Impact Questionnaire and Urogenital Distress Inventory. Urodynamic stress incontinence persistence was evaluated only in patients who had sling surgery., Results: A total of 168 women were recruited for the study. Urodynamic stress incontinence volume was 100 ml for 31% of women, 200 ml for 17%, 300 ml for 17% and 400 ml or greater for 35%. Baseline and postoperative Urogenital Distress Inventory, Incontinence Impact Questionnaire, maximal urethral closure pressure and Valsalva leak point pressure did not differ by urodynamic stress incontinence volume. Among the 116 patients who had the sling procedure, urodynamic stress incontinence persistence did not differ by urodynamic stress incontinence volume (p=0.72)., Conclusions: Women who demonstrate urodynamic stress incontinence at lower bladder volumes do not report greater bother from incontinence than women who leak at higher volumes, suggesting leakage severity on urodynamics is not an adequate reflection of incontinence related quality of life.

Purpose: We assessed the relationships among severity measures of urinary incontinence in women with stress predominant symptoms enrolled in a randomized clinical trial comparing 2 surgical techniques (Burch colposuspension vs pubovaginal sling) for stress urinary incontinence., Materials and Methods: A total of 655 women underwent a standardized preoperative assessment that included the Medical, Epidemiological and Social Aspects of Aging questionnaire, Urogenital Distress Inventory, Incontinence Impact Questionnaire, 3-day voiding diary, 24-hour pad test, a supine empty bladder stress test and Valsalva leak point pressure measurements. Correlations were estimated using Spearman correlation coefficients and 95% confidence intervals. T tests at alpha=0.05 were conducted to compare the distributions of the continuous severity measure between patients with positive and negative supine empty bladder stress test., Results: Baseline mean scores on Medical, Epidemiological and Social Aspects of Aging, Urogenital Distress Inventory and Incontinence Impact Questionnaire were 25.8, 151 and 171, respectively. Mean incontinence episode frequency and pad weight were 3.2 per day and 43.5 gm, respectively. Supine empty bladder stress test was positive in 218 patients, and 428 patients had valid Valsalva leak point pressure measurements with a mean Valsalva leak point pressure of 80 cm H(2)O. Weak to moderate correlations were observed between Medical, Epidemiological and Social Aspects of Aging, incontinence episode frequency, pad weight, Incontinence Impact Questionnaire and Urogenital Distress Inventory. On the other hand, Valsalva leak point pressure correlated poorly with all variables measured. The sensitivity and specificity of the supine empty bladder stress test to predict intrinsic sphincter dysfunction were 49% and 60%, respectively., Conclusions: Urinary incontinence severity measures correlate moderately with each other at best. While Medical, Epidemiological and Social Aspects of Aging demonstrated stronger correlations with the other measures of severity and quality of life, Valsalva leak point pressure did not. Supine empty bladder stress test did not demonstrate a clinically significant association among severity measures.

Purpose: We determined if patient recall of incontinence episodes correlates with urinary diary record., Materials and Methods: Women with 1 or more urge incontinence episode per week completed 2, 7-day diaries, the Urinary Distress Inventory and Incontinence Impact Questionnaire, and responded to 2 recall questions., Results: The median number of incontinence episodes participants recalled (6.5, 5) was higher than those recorded in the diary (1.9, 1.1) at both points. Incontinence episodes in 2, 7-day diaries correlated strongly (rho = 0.921, p <0.005) while participant recall of incontinence episodes correlated weakly (rho = 0.309, p <0.059). When subjects reported being only slightly or not bothered by urge incontinence, recall and diary record correlated strongly (rho = 0.812, p = 0.014). With increasing bother (moderate or great), recall and diary were not significantly correlated (rho = 0.528, p = 0.115)., Conclusions: Women with urge incontinence either overestimate or under record incontinence episode frequency in the urinary diary. This effect is more pronounced in women who are more bothered by incontinence.

Purpose: A relationship between childhood urinary symptoms and adult lower urinary tract symptoms in women is often clinically suspected. In this analysis we investigated the relationship between childhood and adult urinary symptoms in middle-aged women., Materials and Methods: A population based cohort of 2,109 women 40 to 69 years old who were members of a large health maintenance organization was randomly selected from age and race strata. Through self-reported questionnaires, women recalled a childhood history of and current urinary lower urinary tract symptoms, including frequent daytime urination, nocturia, urinary incontinence, nocturnal enuresis and UTIs. Current incontinence was also classified as urge or stress incontinence. Multivariate analysis was used to evaluate the association between childhood and current lower urinary tract symptoms controlling for age, race, hysterectomy status, parity, oral estrogen use, body mass index and diabetes., Results: Women who reported childhood daytime frequency were more likely to report adult urgency (OR 1.9, 95% CI 1.3-2.6, p < 0.001). Frequent nocturia in childhood was strongly associated with adult nocturia (OR 2.3, 95% CI 1.5-3.5, p < 0.001). Childhood daytime incontinence was associated with adult urge incontinence (OR 2.6, 95% CI 1.1-5.9, p < 0.05), as was childhood nocturnal enuresis (OR 2.7, CI 1.3-5.5, p < 0.01). A history of more than 1 childhood UTI was associated with adult UTIs (OR 2.6, 95% CI 1.5-4.5, p < 0.001)., Conclusions: Childhood urinary symptoms and UTIs were significantly associated with adult overactive bladder symptoms. There is a need to investigate the significance of childhood symptoms as predictors of eventual adult disorders to determine whether treatment of childhood symptoms will alter the prevalence of eventual adult disorders, and if such a history should alter clinical care of the older adult with OAB symptoms.