Prevalence, evaluation and management of overactive bladder in primary care

Abstract

Background: Patients with overactive bladder (OAB) are under-diagnosed in the primary care setting. Primary care physicians (PCP) approach to the patient and appropriate patient disclosure may contribute to under-diagnosis.

Methods: An outpatient primary care setting was used to determine the prevalence and characteristics of OAB. Patients who visited the family medicine outpatient clinic were invited to answer a self-administered questionnaire. It included questions on evidence of lower urinary tract symptoms (modified Overactive Bladder-Validated 8-question Screener [OAB-V8]), relevant medical and surgical history, and demographic data. Relationship between OAB and other independent variables were analyzed using chi-square and risk ratio (RR) analysis.

Results: Of 325 questionnaires distributed, 311 were returned completed. Patients ranged from 18 to 97 years, the majority women (74.0%) and African American (74.3%). OAB was present in 60.5% of men and 48.3% of women (p = 0.058). OAB was significantly associated with obesity (BMI > or = 30) in women (p = 0.018, RR = 1.72), specifically obese premenopausal women (age < 55 years) (p = 0.011, RR = 1.98).

Conclusion: OAB prevalence is more than double and higher in men than previously reported. The relative risk for OAB is significantly greater in obese premenopausal women.

Figure 1

Prevalence of OAB subtypes by age and sex. Data represent percent (%) prevalence of male and female patients by age for (A) all subtypes, (B) OAB-U, (C) OAB-UUI, (D) OAB – MUI. OAB-U = OAB with urgency without incontinence, OAB-UUI = OAB with urge urinary incontinence, OAB-MUI = OAB with mixed urinary incontinence.