# Stress and Anxiety Effects on Overactive Bladder: A Controlled Study

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2022 · $399,827

## Abstract

PROJECT SUMMARY
Overactive bladder (OAB) (i.e. urinary urgency, with or without urgency urinary incontinence, frequency, and
nocturia) affects 1 in 7 U.S. men and women and results in substantial impairment to quality of life (QOL). To
help self-manage and cope with OAB, many people adopt compensatory bladder behaviors, such as restricting
fluids, using containment products, strategic planning and mapping restroom access, and even curtailing
activities or travel altogether, which further adversely impact QOL. These behaviors may be driven by anxiety
and stress related to urinary urgency and incontinence episodes as well as ensuing distress and embarrassment.
Prior research has linked anxiety and OAB: up to 40% of women and 30% of men with OAB also have
generalized anxiety disorder. The link between stress and OAB is less studied. In animals, experimental stress
can cause OAB-like symptoms and behaviors as well as bladder and somatic hypersensitivity. In limited human
studies, women with OAB may have greater physiologic and psychologic stress reactivity, and acute stress may
exacerbate urinary urgency. However, how stress impacts on the bladder in the context of OAB or what
psychological factors drive compensatory behaviors that impair QOL in OAB remain unknown, as there are no
highly-controlled studies of anxiety-OAB links. Understanding these relationships would be a critical advance to
individualizing care of patients with OAB. The proposed project will comprehensively investigate for the first time
how stress, anxiety and OAB interact, including the impacts on bladder sensitivity, urinary symptoms, and
compensatory bladder behaviors. We propose a feedforward loop, whereby increased OAB symptoms increase
anxiety (via response to coping with stressful situations), which in turn increases OAB symptoms (via increased
bladder sensitivity). We further propose that compensatory behaviors are driven by anxiety-related learning
processes that help perpetuate this relationship. We will test our hypotheses in a sample of men and women
with OAB and healthy controls. Aim 1 will test the hypothesis that acute, experimentally induced psychological
stress will be more strongly associated with increased bladder sensitivity in OAB patients than in controls, using
a novel bladder sensation meter with oral hydration and stress induction procedures. Aim will test the hypothesis
that psychological stress and anxiety will have concurrent and lagged effects on day-to-day urinary symptoms
that are stronger in individuals with OAB than in controls, using an ecological momentary assessment approach
(7-day electronic diary) to examine prospective associations between everyday perceived stress, anxiety and
urinary symptoms. Aim 3 will test the hypothesis that compensatory behaviors (i.e. coping) used at the time of
voiding will be associated with subsequent reductions in anxiety levels, using a 3-day sensation-related bladder
diary that captures concurrent bladder behavio...

## Key facts

- **NIH application ID:** 10488233
- **Project number:** 5R01DK129624-02
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** William Stuart Reynolds
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $399,827
- **Award type:** 5
- **Project period:** 2021-09-15 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10488233

## Citation

> US National Institutes of Health, RePORTER application 10488233, Stress and Anxiety Effects on Overactive Bladder: A Controlled Study (5R01DK129624-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10488233. Licensed CC0.

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