Issn Print: 1071-5754
Publication Date: 2005/05/01
Assessment of the Patient With an Overactive Bladder
Diane K. Newman
+ Author Information
Author Information: , Co-Director, Penn Center for Continence and Pelvic Health, University of Pennsylvania Medical Center, Philadelphia.
Excerpt
AB is 58 years old and has taught fifth grade in the Philadelphia public school system for the past 30 years. She is distressed. She has lived with urinary urgency and frequency for more than 6 years, but it has been getting worse since her doctor prescribed a diuretic for her high blood pressure. Lately, the urge is so strong she feels she won't make it to the toilet unless she runs. When teaching, she is unable to leave her classroom and frequently doesn't have enough time between classes to go to the bathroom. The other day, AB had a “urinary accident.” Driving home from school, she got a strong urge. She parked the car in the garage, grabbed her shopping bags, and rushed to the door. She fumbled with her keys and couldn't get them in the lock; the urge was so strong that she completely “lost it.” AB wet through her pants. She was so glad she was home and not at school. She has started wearing an ultra thick pad in her underwear as a safeguard against unexpected episodes. During her last routine visit with her doctor, she was asked about her blood pressure but not about possible bladder problems, and she didn't bring up the subject.
The above case study is a typical scenario of a woman suffering from overactive bladder (OAB). Patients tend not to report symptoms, and healthcare providers do not routinely ask patients about bladder control problems as part of an overall health assessment. Despite the high prevalence of OAB, it is consistently underdiagnosed and undertreated, because only 1 out of 4 women (13% to 54%) with symptoms of OAB with urinary incontinence (UI) seeks clinical help.1–3 A contributing factor is the “stigma” surrounding bladder control problems and the fact that patients have many misconceptions about these conditions, thus preventing them from seeking care.4 Patients, particularly women, would prefer that healthcare providers initiate the topic of OAB; therefore, there is a need for improved understanding of the assessment of OAB and increased patient-provider communication about this condition.
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