Symptom bother and health care-seeking behavior among individuals with overactive bladder

Objective: To estimate symptom bother and health care seeking among individuals with overactive bladder (OAB; ie, cases) using current International Continence Society definitions. Methods: This was a nested case-controlled analysis of data from the EPIC study, a population-based, cross-sectional survey of adults in five countries. Cases and matched controls were asked about risk factors, use of coping techniques, and health care seeking for urinary symptoms. Cases were asked about symptom bother and assessed with the Overactive Bladder-Validated 8 and Patient Perception of Bladder Condition instruments. Results: Among cases (n = 1434), 54% reported symptom bother; rates were similar between men (54%) and women (53%). Significantly more men with urinary incontinence (UI) reported bother (77%) than women with UI (67%; p <= 0.05). Among cases with Ul who reported bother, more women (73%) than men (51%) used a urinary symptom coping technique, and the proportions were significantly greater than controls (men: 10%; women: 15%; p <= 0.05 for cases with UI vs. controls). Among cases using coping techniques, 63% of men and 69% of women initiated a conversation with a health care provider. Initiation of conversation with a health care provider was highest among cases who had a doctor visit within 6 mo (odds ratio [OR], 2.8), used coping techniques (OR, 2.2), or reported symptom bother (OR, 2.2). Conclusions: Cases reporting symptom bother, particularly those with UI, were significantly more likely to use coping techniques and seek health care advice. Clinicians should screen for CAB in all cases and assess symptom bother in those affected to guide diagnosis and treatment. (c) 2008 European Association of Urology. Published by Elsevier B.V. All rights reserved.