Family Practice Advance Access originally published online on May 26, 2006
Family Practice 2006 23(5):568-577; doi:10.1093/fampra/cml018
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Perceptions and behaviours of women with bladder control problems
a Department of Urology, William Beaumont Hospital Royal Oak, MI, USA
b Division of Urogynecology, Evanston Continence Center, Northwestern University Medical School Evanston, IL, USA
c Department of Urology, Wake Forest University School of Medicine Winston-Salem, NC, USA
d Ortho-McNeil Neurologics Inc. Titusville, NJ, USA
Correspondence to: Ananias C. Diokno, M.D., William Beaumont Hospital, 3535 West 13 Mile Road, Suite 438, Royal Oak, MI 48073-6710, USA; E-mail adiokno{at}beaumont.edu
Objectives. To evaluate women's perceptions about bladder control problems.
Methods. 757 women with one or more bladder control symptoms (frequency, urgency, stress or urge urinary incontinence and nocturia) participated in an Internet-based survey. A separate study involved 12 focus groups including a total of 180 women with bladder control problems.
Results. Respondents in the survey reported multiple symptoms, e.g. stress urinary incontinence (72%), frequency (56%), nocturia (45%), urge urinary incontinence (43%) and urgency (33%). Women in both the survey and the focus groups revealed extensive use of coping mechanisms to manage their symptoms. The focus groups revealed that many women were not aware that overactive bladder (OAB) is a pathophysiological condition. Approximately 30% of respondents in the survey felt uncomfortable talking to their doctor about their condition. Among women who did speak with their doctor, stress-related symptoms were described more readily than urge-related symptoms. In the survey, only about half (56%) of the women felt their OAB medication was effective, and half (50%) stopped taking their medication at some point. Information from the focus groups suggested that some women may have unrealistic expectations of onset of efficacy or extent of benefit and may be unprepared for managing side effects.
Conclusions. Feelings of embarrassment and limited understanding of the pathophysiology of OAB can contribute to miscommunication between a woman and her doctor. Patient education regarding reasonable expectations coupled with suggestions for coping with unwanted side effects will likely result in better management.
Keywords. Overactive bladder, population-based survey, women, behaviours, attitudes.