The patient's perspective: redefining end points

Overactive bladder (OAB) is a common symptom syndrome that has a considerable effect on quality of life (QOL) and that may contribute to the development of other disabling conditions. Whereas all symptoms of OAB are associated with reductions in QOL, urge incontinence appears to have the greatest negative consequences. Goals of OAB therapy should be to improve symptoms, with a subsequent improvement in QOL. The best tools for evaluating the effects of OAB therapies on QOL remain to be determined. In the past, objective end points, including the reduction of urge incontinence episodes and number of micturitions per 24 hours, have been used to assess the efficacy of pharmacologic agents in the treatment of OAB. However, the subjective nature of OAB demands novel tools to assess patient perception of treatment outcome. In 2 recent studies with the antimuscarinic agent tolterodine, it is suggested that the King's Health Questionnaire is sensitive to therapy-related changes in QOL in patients with OAB, but additional methods to measure patient benefit are still needed.