A cross-sectional study in the USA of the epidemiology and quality of life of underactive bladder symptoms.

PURPOSE: To assess the prevalence, awareness, and quality of life (QOL) impact of symptoms suggestive of underactive bladder (UAB) in the USA. METHODS: A thirteen-item paper survey was mailed to 25,000 individuals 60 years or older living in the USA. It aimed to collect information relating to demographics, familiarity with UAB, patient urinary symptoms, and QOL concerns. RESULTS: Nine hundred and seventy-seven survey participants were stratified into four groups based on the number of UAB symptoms (straining, retention, and difficulty emptying) present: zero, one, two, and three. As the number of reported UAB symptoms increased, there was an increase prevalence in nocturia, urge, and urinary frequency (p < 0.0001). Increased UAB symptoms were associated with an increased prevalence of concerns related to urgency, urge incontinence, nocturia, and overall urinary status (p < 0.0001). Urology visits were most common in individuals who reported the most UAB symptoms (p < 0.0001); however, there was no difference among groups with regard to UAB awareness. Women were less likely to report any UAB symptoms (p < 0.0001), symptoms of urge (p = 0.001), retention (p = 0.002), difficulty emptying their bladder (p < 0.0001), a history of catheter use for retention (P = 0.002), and urology visits in the past 3 years (p < 0.0001). This study is limited in its inability to differentiate UAB from disorders that may mimic UAB clinically, based on the survey questions asked. CONCLUSIONS: Underactive bladder symptoms are common and can have a significant impact on ones QOL, although awareness is still lacking among potentially affected individuals. More must be done to allow one to better differentiate between UAB and conditions that are clinically similar.

Epidemiology and demographics of the underactive bladder: a cross-sectional survey.

The aim of this study was to evaluate the prevalence and awareness of symptoms suggestive of underactive bladder (UAB) in a heterogeneous, non-specific population to garner additional epidemiologic information about UAB. After IRB approval, an 18-item survey was mailed to 5,000 people living in metro Detroit to collect demographic data and questions regarding clinical urinary symptoms and familiarity with UAB. A total of 633 subjects (13; 54 % men, 46 % women) returned the survey. Nearly one quarter (23 %, n = 137) of respondents reported difficulty emptying his/her bladder, yet only 11 % (n = 70) had ever heard of UAB. The study results indicated that patient-reported bladder emptying symptoms are prevalent, as common in women as men, and significantly associated with comorbidity and poor self-reported health. The results suggest that the burden and impact of UAB might be significant and that a syndromic concept of UAB warrants research to determine the true burden of disease, increase awareness, and broaden efforts to investigate therapeutic directions.

Defining and advancing education and conservative therapies of underactive bladder.

In contrast to other forms of voiding dysfunction, underactive bladder (UAB) has traditionally received little research or educational attention. This is changing as our understanding of the underlying mechanisms of detrusor dysfunction and other forms of underactive bladder improves. In addition, the impact of UAB on patient symptoms, general and health-related quality of life, and caregiver burden are becoming more recognized. However, there remains a paucity of data on the subject, and an extensive need for additional research and education on the topic. This paper explores the current state of knowledge about UAB with an emphasis on education regarding the condition and conservative methods of assessment and treatment. Recommendations for future work in this area are considered.

Optimum Management of Overactive Bladder: Medication vs Botox® vs InterStim® vs Urgent® PC.

INTRODUCTION: Optimal management of the overactive bladder is changing quickly, and urology practices need to stay in the vanguard of offering safe and effective therapies when anticholinergics are not effective or not tolerated. METHODS: We will review approved therapies for overactive bladder prescribed after behavioral therapy and anticholinergic medications have failed. RESULTS: The treatment failure rate of anticholinergics is high and does not improve with the use of multiple drugs. Therefore, we propose a new treatment paradigm that will stop anticholinergic cycling. CONCLUSIONS: We believe that it is time to get patients off the anticholinergic cycle and move forward with effective alternative treatments to optimize overactive bladder therapy.