Pre-Existing Nocturia Status Predicts Bladder Symptom Exacerbation Following COVID-19 Vaccination in Women

Purpose Bladder sensory symptoms following COVID-19 vaccination have received little attention, particularly in women. This study aimed to determine whether COVID-19 vaccination exacerbates lower urinary tract symptoms (LUTS) in women and to identify predictors of symptom deterioration. Methods We conducted a cross-sectional survey of 594 Taiwanese women who received at least one dose of COVID-19 vaccine between October 2021 and January 2022. Participants completed validated Chinese versions of the Interstitial Cystitis Symptom Index (ICSI) and Problem Index (ICPI) before and after vaccination. Subjects were stratified based on baseline nocturia status, and logistic regression was used to identify risk factors for symptom worsening. Results Post-vaccination, significant increases were observed in ICSI scores for frequency, nocturia, urgency, bladder pain and total score as well as ICPI scores for frequency, nocturia and urgency (all p < 0.05). Notably, 20.7% of women experienced ICPI score deterioration, and 5.2% sought medical attention for urinary complaints. Women with pre-existing nocturia had significantly greater increases in ICPI scores (+0.70 vs. –0.27, p < 0.001). In multivariable analysis, pre-existing nocturia (aOR 3.53, 95% CI 2.29–5.21, p < 0.001) and hyperlipidemia (aOR 3.42, 95% CI 1.24–9.46, p = 0.018) were independent predictors of ICPI deterioration. No significant predictors were found for ICSI score changes. Conclusions COVID-19 vaccination is associated with mild but measurable exacerbation of bladder sensory symptoms in a subset of women, especially those with pre-existing nocturia or metabolic comorbidities. These findings highlight the need for risk-based counseling and post-vaccination monitoring in susceptible female populations.