Chlamydia and Urinary Incontinence
Latent chlamydia infection can potentially cause urinary incontinence, particularly urge incontinence associated with urethral instability. 1
Connection Between Chlamydia and Urinary Symptoms
- Chlamydia trachomatis primarily affects the genitourinary tract and can cause dysuria (painful urination) in both men and women 2, 3
- While not typically listed among the common complications of chlamydia, research has found a significant association between chlamydial urethral infection and urethral instability leading to urge incontinence 1
- In a study of 168 patients with urinary incontinence, C. trachomatis was found in 7.7% overall, but was significantly more common in those with urethral instability compared to those with stable urethra 1
Pathophysiology and Clinical Relevance
- Chlamydia can cause inflammation of the urethra (urethritis), which may contribute to urinary symptoms including potential incontinence 3, 4
- Chlamydial infections are often asymptomatic, making them difficult to detect without screening 2, 5
- When chlamydia ascends in the male reproductive tract, it typically causes epididymitis rather than prostatitis 3
- In women, chlamydia can cause acute dysuria-pyuria syndrome with sterile urine cultures, which could be mistaken for other urinary conditions 2
Treatment and Outcomes
- Treatment with appropriate antibiotics (doxycycline) resulted in clinical and urodynamic improvement in 8 out of 9 patients with urethral instability and chlamydial infection 1
- Standard treatment for uncomplicated chlamydial infections includes azithromycin or doxycycline 5
- Both the infected individual and their sexual partners should be treated to prevent reinfection 6
Important Clinical Considerations
- Urinary symptoms in the absence of positive standard urine cultures should raise suspicion for chlamydial infection 4
- Chlamydia is the most common sexually transmitted infection in the United States, with over 1 million infections annually 5
- Screening is recommended for all women under 25 years, pregnant women, and those at increased risk of infection 5, 7
- Special culture techniques and transport media are required for proper detection of chlamydia 6
- Nucleic acid amplification tests (NAATs) are the preferred method for detecting C. trachomatis 3
Potential Complications if Untreated
- Beyond urinary symptoms, untreated chlamydial infections can lead to serious complications including pelvic inflammatory disease, infertility, and ectopic pregnancy in women 5, 7
- In men, complications can include epididymitis and orchitis 5
- Both men and women can develop reactive arthritis as a complication of chlamydial infection 8, 5
- Chronic or recurrent infections with C. trachomatis have been recognized as a significant factor in the development of acute or chronic renal interstitial inflammation 4