Neural crosstalk and symptom overlap: The correlation between urinary and intestinal symptoms in patients undergoing colonoscopy

Purpose: Neural crosstalk in the pelvis involves intrinsic communication networks among pelvic structures that direct afferent inputs to converge on neurons, leading to viscerovisceral and somatovisceral reflexes. We aimed to explore the overlap between intestinal and urinary symptoms and their corr...

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Main Authors: Pedro Henrique P. Costa, Paulo Rodrigues, Lucas S. Takemura, Marina A. Germano, Mariane Ellen S. Sales, Gustavo A. de Paulo, Bianca Bianco, Maria Beatriz Lemos, Gustavo C. Lemos, Arie Carneiro
Format: Article
Language:English
Published: Korean Urological Association 2025-05-01
Series:Investigative and Clinical Urology
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Online Access:https://www.icurology.org/pdf/10.4111/icu.20240377
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author Pedro Henrique P. Costa
Paulo Rodrigues
Lucas S. Takemura
Marina A. Germano
Mariane Ellen S. Sales
Gustavo A. de Paulo
Bianca Bianco
Maria Beatriz Lemos
Gustavo C. Lemos
Arie Carneiro
author_facet Pedro Henrique P. Costa
Paulo Rodrigues
Lucas S. Takemura
Marina A. Germano
Mariane Ellen S. Sales
Gustavo A. de Paulo
Bianca Bianco
Maria Beatriz Lemos
Gustavo C. Lemos
Arie Carneiro
author_sort Pedro Henrique P. Costa
collection DOAJ
description Purpose: Neural crosstalk in the pelvis involves intrinsic communication networks among pelvic structures that direct afferent inputs to converge on neurons, leading to viscerovisceral and somatovisceral reflexes. We aimed to explore the overlap between intestinal and urinary symptoms and their correlations in patients undergoing colonoscopy. Materials and Methods: Cross-sectional study with 167 participants who underwent colonoscopy and were assessed using three self-administered questionnaires: the International Prostate Symptom Score (IPSS) for lower urinary tract symptoms, the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) for overactive bladder symptoms, and the Gastrointestinal Symptom Rating Scale (GSRS) for gastrointestinal (GI) symptoms. Results: Among the participants, 55.1% were male, and the median age was 57 years. Most colonoscopies (80.8%) were performed for screening, and the most common finding was diverticular disease (DD) (35.9%). The IPSS and ICIQ-OAB were strongly correlated (rho=0.544, p<0.001), while the IPSS and GSRS scores showed a moderate correlation (rho=0.304, p<0.001). In the DD subgroup, both ICIQ-OAB and IPSS (rho=0.568, p<0.001), and IPSS and GSRS (rho=0.493, p<0.001) showed strong correlations. In contrast, the subgroup without DD showed a strong correlation between the ICIQ-OAB and IPSS (rho=0.510, p<0.001), but only a weak correlation between the IPSS and GSRS (rho=0.188, p=0.057), suggesting that the urinary-GI connection is influenced by the presence of DD. Conclusions: The findings revealed intrinsic relationships between urinary and GI symptoms, with DD as a significant factor influencing these relationships, suggesting that a more integrated approach to evaluate and manage these patients can potentially improve diagnostic accuracy and treatment outcomes.
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spelling doaj-art-b7c31bc792eb4e14a629d522fe7903a02025-08-20T03:53:12ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2025-05-0166325126010.4111/icu.20240377Neural crosstalk and symptom overlap: The correlation between urinary and intestinal symptoms in patients undergoing colonoscopyPedro Henrique P. Costa0https://orcid.org/0009-0009-1326-843XPaulo Rodrigues1https://orcid.org/0000-0002-7397-5277Lucas S. Takemura2https://orcid.org/0000-0001-6683-5797Marina A. Germano3https://orcid.org/0009-0004-0897-7411Mariane Ellen S. Sales4https://orcid.org/0009-0008-3809-2736Gustavo A. de Paulo5https://orcid.org/0000-0002-7926-9373Bianca Bianco6https://orcid.org/0000-0001-8669-3562Maria Beatriz Lemos7https://orcid.org/0009-0001-2285-5136Gustavo C. Lemos8https://orcid.org/0000-0001-8818-4964Arie Carneiro9https://orcid.org/0000-0002-0152-0513Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), São Paulo, Brazil.Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), São Paulo, Brazil.Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil.Purpose: Neural crosstalk in the pelvis involves intrinsic communication networks among pelvic structures that direct afferent inputs to converge on neurons, leading to viscerovisceral and somatovisceral reflexes. We aimed to explore the overlap between intestinal and urinary symptoms and their correlations in patients undergoing colonoscopy. Materials and Methods: Cross-sectional study with 167 participants who underwent colonoscopy and were assessed using three self-administered questionnaires: the International Prostate Symptom Score (IPSS) for lower urinary tract symptoms, the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) for overactive bladder symptoms, and the Gastrointestinal Symptom Rating Scale (GSRS) for gastrointestinal (GI) symptoms. Results: Among the participants, 55.1% were male, and the median age was 57 years. Most colonoscopies (80.8%) were performed for screening, and the most common finding was diverticular disease (DD) (35.9%). The IPSS and ICIQ-OAB were strongly correlated (rho=0.544, p<0.001), while the IPSS and GSRS scores showed a moderate correlation (rho=0.304, p<0.001). In the DD subgroup, both ICIQ-OAB and IPSS (rho=0.568, p<0.001), and IPSS and GSRS (rho=0.493, p<0.001) showed strong correlations. In contrast, the subgroup without DD showed a strong correlation between the ICIQ-OAB and IPSS (rho=0.510, p<0.001), but only a weak correlation between the IPSS and GSRS (rho=0.188, p=0.057), suggesting that the urinary-GI connection is influenced by the presence of DD. Conclusions: The findings revealed intrinsic relationships between urinary and GI symptoms, with DD as a significant factor influencing these relationships, suggesting that a more integrated approach to evaluate and manage these patients can potentially improve diagnostic accuracy and treatment outcomes.https://www.icurology.org/pdf/10.4111/icu.20240377diverticular diseaseslower gastrointestinal tractlower urinary tract symptomspelvic painurinary incontinence
spellingShingle Pedro Henrique P. Costa
Paulo Rodrigues
Lucas S. Takemura
Marina A. Germano
Mariane Ellen S. Sales
Gustavo A. de Paulo
Bianca Bianco
Maria Beatriz Lemos
Gustavo C. Lemos
Arie Carneiro
Neural crosstalk and symptom overlap: The correlation between urinary and intestinal symptoms in patients undergoing colonoscopy
Investigative and Clinical Urology
diverticular diseases
lower gastrointestinal tract
lower urinary tract symptoms
pelvic pain
urinary incontinence
title Neural crosstalk and symptom overlap: The correlation between urinary and intestinal symptoms in patients undergoing colonoscopy
title_full Neural crosstalk and symptom overlap: The correlation between urinary and intestinal symptoms in patients undergoing colonoscopy
title_fullStr Neural crosstalk and symptom overlap: The correlation between urinary and intestinal symptoms in patients undergoing colonoscopy
title_full_unstemmed Neural crosstalk and symptom overlap: The correlation between urinary and intestinal symptoms in patients undergoing colonoscopy
title_short Neural crosstalk and symptom overlap: The correlation between urinary and intestinal symptoms in patients undergoing colonoscopy
title_sort neural crosstalk and symptom overlap the correlation between urinary and intestinal symptoms in patients undergoing colonoscopy
topic diverticular diseases
lower gastrointestinal tract
lower urinary tract symptoms
pelvic pain
urinary incontinence
url https://www.icurology.org/pdf/10.4111/icu.20240377
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