Overactive bladder (OAB), characterized by urgency, frequency, and/or urgency urinary incontinence (UI), is common in women (1). Fibromyalgia (FM) is a female-predominant disorder characterized by widespread musculoskeletal pain and somatic symptoms (2). Although OAB prevalence is reported to be higher in patients with FM, data on FM prevalence in women with OAB are limited (2,3). This study aimed to investigate the prevalence of FM in women with OAB and its relationship with OAB severity.

This prospective, cross-sectional study included women aged 18–65 years with OAB and age-matched healthy controls. OAB was defined according to the International Continence Society (ICS).
Participants with OAB were evaluated using a 3-day bladder diary, 1-hour pad test, Overactive Bladder Symptom Score (OABSS), and International Consultation on Incontinence Questionnaire–Female Lower Urinary Tract Symptoms (ICIQ-FLUTS).
Fibromyalgia was diagnosed according to the 2016 revised diagnostic criteria of the American College of Rheumatology (ACR). In participants fulfilling FM criteria, severity was assessed using the Revised Fibromyalgia Impact Questionnaire (FIQR). Somatic symptom severity was evaluated using the DSM-5 Level 2 Somatic Symptom Scale–Adult, and physical activity using the International Physical Activity Questionnaire–Short Form (IPAQ-SF).
Sample size calculation (95% power, α=0.05) indicated inclusion of 120 participants. All participants provided informed consent.

A total of 120 women were included (60 OAB, 60 controls). Median age was similar between groups (45.5 [24–64] vs 41.5 [23–64], p>0.05), while BMI was higher in the OAB group (26.74 [18.3–44.3] vs 23.62 [18.1–37.6], p<0.05).
Among women with OAB, 88.3% had UI; 38.3% had pure OAB and 61.7% had urge-predominant mixed UI.
FM prevalence was higher in the OAB group (41.7% vs 5.0%, p<0.05). Median OABSS was higher in OAB patients with FM compared to those without FM (9 [2–14] vs 7 [4–13], p<0.05). However, bladder diary parameters, pad test results, and ICIQ-FLUTS scores did not differ between groups. FM severity (FIQR) was not correlated with OAB severity.
Somatic symptom severity was higher in women with OAB and was associated with increased ICIQ-FLUTS total and incontinence scores (p<0.05) and a higher likelihood of wet OAB. In contrast, OABSS, bladder diary, and pad test results were not associated with somatic symptom severity.

Women with OAB showed a higher prevalence of FM and greater somatic symptom burden compared to controls. OAB patients with FM had higher symptom scores, although FM severity was not associated with OAB severity and objective measures did not differ. Increased somatic symptom severity was related to worse patient-reported outcomes and a higher likelihood of wet OAB, suggesting an influence on symptom experience beyond objective findings.

Fibromyalgia is highly prevalent in women with OAB and is associated with greater symptom burden. However, the lack of association between FM severity and objective OAB measures suggests a complex relationship beyond disease severity. Clinicians should consider the coexistence of FM and somatic symptoms in OAB management. Further research is needed to clarify its clinical implications.

Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002;21:167–178.
Kurtulus D, Arkan K, Suceken FY, Akgol S, Can B. Assessment of Overactive Bladder in Women With Fibromyalgia Presenting With Lower Urinary Tract Symptoms: A Controlled Clinical Study. Neurourol Urodyn. Feb 2026;45(2):318-23
Soyupek F, Soyupek S, Akkus S, Ozorak A. The Coexistence of the Fibromyalgia Syndrome and the Overactive Bladder Syndrome. J Musculoskelet Pain. 2007;15(3):31-7