Author
Milsom I, Stewart W, Thuroff J
Date
7/2000
Journal
Am J Manag Care
Abstract
Overactive bladder (OAB) is a disorder that encompasses frequency, urgency, and urge incontinence, singly or in combination. It often has a significant individual impact on quality of life and on limitations to activities, yet most individuals with OAB do not seek medical care. Therefore, it is not possible to estimate the prevalence and, more generally, the societal impact of OAB based on medical encounter data. With few exceptions, most epidemiologic studies have focused on urge incontinence, the most severe form of OAB. The prevalence of OAB increases with age and is more common in women than men. However, prevalence estimates vary considerably among studies, ranging from 3% to 43%. The variation in estimates from epidemiologic studies is the result in part of differences in the criteria used to define a case of urge incontinence among studies. This problem is attributable in part to the lack of a standardized, validated, and operational definition. Nonetheless, consensus exists regarding the significant individual and societal impact of urge incontinence and the recognition that it is underdiagnosed and undertreated. Frequency and urgency, the other 2 symptoms of OAB, have not received the same level of attention as urge incontinence, yet the societal impact of these symptoms of OAB may be considerably greater. Overall, frequency and urgency are considerably more common symptoms than urge incontinence, especially between 35 and 55 years of age, the period of peak productivity for most workers. Recent evidence indicates that a substantial proportion of individuals with frequency and urgency report a diminished quality of life and interference with activities in a number of roles, including work. Efforts are under way to more accurately describe the prevalence of frequency and urgency, using a validated and standardized epidemiologic case definition to determine the individual impact of each symptom of OAB and to estimate societal costs.
