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Understanding the elements of overactive bladder: questions raised by the EPIC study
Debra E Irwin1, Paul Abrams, Ian Milsom
1Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599, USA. dirwin@email.unc.edu
BJU International
|March 14, 2008
Summary
Standardizing definitions for overactive bladder (OAB) symptoms like daytime frequency and nocturia is crucial for accurate assessment. Current International Continence Society (ICS) definitions effectively capture symptom bother in OAB patients.
Area of Science:
- Urology
- Public Health
- Gerontology
Background:
- Overactive bladder (OAB) syndrome is characterized by lower urinary tract symptoms (LUTS), including urgency, frequency, and nocturia.
- Standardized definitions are essential for consistent diagnosis and management of OAB.
- The impact of LUTS on quality of life, particularly symptom bother, is a key consideration in OAB assessment.
Purpose of the Study:
- To compare the prevalence and bother of daytime frequency and nocturia using current International Continence Society (ICS) definitions versus alternative criteria.
- To highlight the importance of standardized LUTS definitions in evaluating OAB syndrome.
- To describe the spectrum of LUTS and associated bother in a population with OAB.
Main Methods:
- A population-based, cross-sectional telephone survey was conducted in five countries.
- Participants aged 18 years or older were included.
- OAB was defined using ICS criteria for urgency or urgency urinary incontinence.
- Daytime frequency and nocturia prevalence were assessed using ICS definitions and alternative thresholds.
- Symptom bother associated with frequency and nocturia was compared across different criteria.
Main Results:
- 1434 participants with OAB were identified.
- ICS-defined daytime frequency was present in 31% of men and 25% of women with OAB.
- Over half of the OAB population reported daytime frequency as bothersome.
- Approximately 75% of OAB patients reported nocturia (one or more episodes per night), with bother increasing with episode frequency.
- The most common OAB symptom combination was urgency and nocturia.
- The number of LUTS and associated bother increased with age.
Conclusions:
- ICS definitions for daytime frequency and nocturia adequately capture symptom bother in the OAB population.
- Urgency alone was less bothersome than when combined with other LUTS.
- OAB is often characterized by a combination of urgency with other LUTS.
- Increased number of reported LUTS correlates with increased symptom bother.
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