Definition and epidemiology of overactive bladder
Section snippets
Past definition
It is interesting that, although much argument was engendered by the use of the term OAB, this term was never actually defined or described by the ICS in any prior terminology reports. Overactive detrusor function (generally shortened to overactive detrusor) does appear,1 and this term is defined as a condition characterized by involuntary detrusor contractions during the filling phase of cystometry, which may be spontaneous or provoked. Overactive detrusor function was then divided into
Epidemiology: prevalence
Little definite epidemiologic information was available on the prevalence of OAB until very recently. Nearly all epidemiologic studies in this area have focused on urinary incontinence. The prevailing method for estimating the prevalence of OAB seems to have been to take the prevalence of urinary urge incontinence (including mixed incontinence) and multiply by 3, estimating that approximately 33% of patients with OAB had urinary urge incontinence. The remaining patients did not, complaining
Epidemiology: quality of life and comorbidities
In the study by Milsom et al.,10 65% of men and 67% of women with OAB reported that their symptoms had an effect on daily living, and 60% of those with symptoms found them bothersome enough to consult a medical practitioner. Frequency and urgency alone (59%) were almost as common as urge incontinence (66%) as reasons for seeking help. Of those who sought medical care, only 27% were receiving medication for symptoms at the time of the interview. Of those who were not taking medication, 27% had
Associated costs
In this area, as in many others, analyses of the economic implications of OAB, separate from incontinence, are essentially nonexistent. Wagner and Hu17 reported the total costs of urinary incontinence in the United States in 1995 to be $26,292,400,000. Of these, direct costs accounted for $25.6 billion and indirect costs for $700 million. It is imperative that a similar analysis be performed for patients with OAB, including those with OAB wet and OAB dry. Only by quantification of the total
Conclusion
OAB is a highly prevalent disorder that affects the lives of millions of people worldwide. The importance of OAB as a term has been recognized by the ICS, which now incorporates this term in its lexicon as a symptom syndrome. Prevalence of OAB, as distinct from urinary incontinence, is now the subject of some well-performed surveys, and, through these, we are beginning to be able to characterize the disorder in terms of various demographic features. Data on the effects on quality of life and
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