Defining and managing overactive bladder: disagreement among the experts

Area of Science:

• Urology
• Gynecology
• Geriatrics
• Women's Health

Background:

• Overactive bladder (OAB) is defined by the International Continence Society as urinary urgency, with or without incontinence, frequency, and nocturia.
• The current definition may encompass diverse clinical conditions, prompting expert review.
• Understanding expert perceptions is crucial for refining OAB diagnosis and management.

Purpose of the Study:

• To investigate expert opinions on the current definition of overactive bladder (OAB).
• To explore expert perspectives on the evaluation and treatment strategies for OAB in women.
• To identify areas of consensus and disagreement among specialists.

Main Methods:

• Qualitative study involving 12 in-depth interviews with leading urologic, gynecologic, and geriatric practitioners.
• Interviews focused on experts' perceptions and agreement with the existing OAB definition.
• Grounded theory methodology was employed for verbatim transcription and data analysis.

Main Results:

• Significant variability exists in expert definitions and management approaches to OAB.
• Four distinct definitional categories emerged: adequate, symptom constellation, including fear of leakage, and marketing term.
• While some consensus on evaluation exists, specific elements remain debated. Experts perceive OAB as chronic, incurable, and challenging to treat, with symptom variability.

Conclusions:

• Experts exhibit disagreement regarding the precise definition and diagnostic workup of overactive bladder (OAB).
• A consensus exists among experts that OAB is a chronic condition with a low probability of cure.
• Behavioral therapy is highlighted as a key management focus for OAB.