The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well‐being in men and women: results from the EPIC study

Abstract

OBJECTIVES To examine the effect overactive bladder (OAB) and other lower urinary tract symptoms (LUTS) on health‐related quality of life (HRQoL) in a population sample, as OAB often occurs in conjunction with many other LUTS. SUBJECTS AND METHODS A nested case‐control analysis was performed on men and women with (cases) and without (controls) OAB, from the EPIC study. OAB was assessed using 2002 International Continence Society definitions. Based on their responses to questions about LUTS, cases were classified into five groups; continent OAB, OAB with incontinence, OAB + postmicturition, OAB + voiding, and OAB + postmicturition + voiding. Both cases and controls were asked questions about symptom bother (OAB‐q), generic QoL (EQ‐5D), work productivity (Work Productivity and Activity Impairment, WPAI), depressive symptoms (Center for Epidemiologic Studies Depression Scale), sexual satisfaction, and erectile dysfunction (men only) using the Massachusetts Male Aging Study. Cases answered additional condition‐specific questions HRQoL (OAB‐q short form), Patient Perception of Bladder Condition and work productivity related to a specific health problem (WPAI‐SHP). General linear models were used to evaluate group differences. RESULTS Of the EPIC participants, 1434 identified OAB cases were matched by age, gender and country, with 1434 participants designated as controls. Cases and controls were primarily Caucasian (96.2% and 96.7%, respectively), and most (65%) were female; the mean age was 53.8 and 53.7 years, respectively. Comorbid conditions differed significantly by case/control status, with cases reporting significantly greater rates of chronic constipation, asthma, diabetes, high blood pressure, bladder or prostate cancer, neurological conditions and depression. There were significant differences between the cases and controls in all reported LUTS. The OAB + postmicturition + voiding group reported significantly greater symptom bother, worse HRQoL, higher rates of depression and decreased enjoyment of sexual activity, than the other subgroups. CONCLUSION OAB has a substantial, multidimensional impact on patients; OAB with additional LUTS has a greater impact. The diagnosis and treatment of OAB should be considered in conjunction with other LUTS, to maximize treatment options and optimize patient outcomes.

Cost-effectiveness of solifenacin compared with oral antimuscarinic agents for the treatment of patients with overactive bladder in the UK

“…Symptoms experienced by patients with OAB can profoundly and negatively affect many aspects of health-related quality of life (HRQoL), including psychological, social, occupational, and sexual function [2]. Individuals with OAB report significantly lower HRQoL scores compared with matched controls, indicating impaired overall health [2]. …”

Overactive bladder in men: initial assessment

“…7 Storage LUTS have been associated with depression, hypertension, irritable bowel syndrome, recurrent UTIs, elevated body mass index and childhood nocturnal enuresis, and may increase the prevalence of falls, fractures and skin infections. 8,9 IMPACT OF OAB Patients with OAB have a considerably lower quality of life, work productivity, sexual satisfaction and quality of sleep; they also have higher rates of depression, and slightly poorer overall health. 9 Given the emotional and personal context of these effects, clinicians have a key role in the assessment and holistic management of OAB.…”

“…8,9 IMPACT OF OAB Patients with OAB have a considerably lower quality of life, work productivity, sexual satisfaction and quality of sleep; they also have higher rates of depression, and slightly poorer overall health. 9 Given the emotional and personal context of these effects, clinicians have a key role in the assessment and holistic management of OAB. There can be a mixture of storage and voiding LUTS and, if there are concerns regarding voiding LUTS, a flow rate and residual may be helpful.…”

Economic evaluation of sacral neuromodulation in overactive bladder: A Canadian perspective

“…[4][5][6] The pathology of the disorder suggests a disruption of the spinal reflex mechanism that carries sensory signals from autonomic and somatic pathways from the bladder outlet and tonic inhibitory system in the brain. 7 This disruption creates inhibits the control function of the parasympathetic excitatory outflow of the urinary bladder. 5 OAB can have substantial impact on a patient's quality of life, such as decreased work productivity, sexual dissatisfaction, erectile dysfunction, depression, poorer mental health, and lack of sleep.…”