OBJECTIVE: This study aims to investigate the relationship between HPV-associated LSIL and HSIL lesions and overactive bladder (OAB) symptoms in postmenopausal women, highlighting the role of severe histopathological lesions. MATERIALS AND METHODS: A retrospective analysis was conducted on postmenopausal women aged 40-65 years who presented at Istanbul Bakırköy Sadi Konuk Training and Research Hospital between January 2021 and March 2023. The study included HPV-positive patients with low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL), as well as HPV-negative controls. OAB symptoms were assessed using the UDI-6, IIQ-7, and OAB-V8 questionnaires. Statistical comparisons were made between HPV-positive and HPV-negative groups, as well as between LSIL and HSIL subgroups. RESULTS: No significant differences were observed in UDI-6, IIQ-7, and OAB-V8 scores between HPV-positive and HPV-negative patients. However, HSIL patients exhibited significantly higher scores on these questionnaires compared to LSIL patients (p <
0.01), indicating a greater severity of OAB symptoms. Additionally, there was a significant positive correlation between questionnaire scores and variables such as age, gravida, parity, and menopause duration. CONCLUSION: HSIL in HPV-positive women is associated with increased severity of OAB symptoms, suggesting a role for HPV-induced inflammation in OAB pathogenesis.