The prevalence of clinically meaningful overactive bladder: Bother and quality of life results from the population-based FINNO study

<p>Background: Wide variation exists in prevalence estimates of overactive bladder (OAB) syndrome. Objective: To determine how the frequency of urinary urgency or urgency urinary incontinence (UUI) - the cornerstone symptoms of OAB - affects symptom-related bother, health-related quality of life (HRQL), and ultimately clinically meaningful prevalence. Design, setting, and participants: Questionnaires were mailed to 6000 subjects (18-79 yr of age) randomly identified from the Finnish Population Register in 2003-2004. Measurements: The frequency (scale: never, rarely, often, always) and bother (scale: none, small, moderate, major) of urgency and UUI were assessed using the Danish Prostatic Symptom Score (DAN-PSS). HRQL was measured with the generic 15D instrument. For HRQL analyses, respondents were classified according to six symptom categories by frequency of urgency and UUI. Results and limitations: Of those subjects queried, 62.4% responded to the survey (53.7% female). Any urgency was reported by more than half of all respondents (54.2% [95% confidence interval (CI), 51.6-56.7] of men: 56.9% [95% CI, 52.9-61.0] of women), whereas any UUI was reported by one in nine men (10.7% [95% CI, 8.9-12.4]) and one in four women (25.7% [95% CI, 22.8-28.7]). However, only one in seven of all respondents with urgency and less than one in three with UUI reported at least moderate bother. With increasing OAB severity, statistically significant decreases were found in the total 15D score and on all 15D dimensions (p <0.001 for all). Reporting often urgency without UUI or rare urgency with rare UUI is associated with a clinically important decrease in HRQL. Although the response proportion was high, approximately one-third of those contacted did not participate. Conclusions: Increased severity of urgency and UUI is associated with a statistically significant and clinically important decrease in HRQL. Assessing bother associated with OAB drastically modifies the measured OAB prevalence and accounts for variation among studies.</p>