Overactive Bladder is a Dynamic Syndrome

Abstract

In their interesting study, Wennberg et al reported the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) in the same group of women over a 16-yr span [1]. The incidence of UI and OAB increased from 1991 to 2007, with a certain percentage of women having symptom regression and progression. Although several studies reported progression or remission of UI or OAB in the short term, this is the first large-scale longitudinal study of UI and OAB in women over a long period. The results of this study indicate that occurrence of UI or OAB symptoms are dynamic. Although OAB could be a progressive condition, some women may have regression with time. OAB and LUTS are highly prevalent in women both in Western and in Eastern countries [2,3]. The influence of aging, menopause, and parturition add complexity to the etiology of female OAB and LUTS. According to Wennberg et al, the incidence of UI increased from 15% in 1991 to 28% in 2007 [1]. Among these women with UI, 12% reported stress urinary incontinence (SUI) and 2% reported urgency UI (UUI) in 1991, whereas in 2007, 19% reported SUI and 12% reported UUI. This result is similar to data reported by Chen et al showing that the occurrence of SUI increased with age up to 65 yr but OAB increased in women >65 yr [3]. OAB symptoms are frequently mixed with SUI. The aging process results in intrinsic urethral sphincteric deficiency, which increases the prevalence of UI and may potentiate the occurrence of detrusor overactivity (DO) and OAB symptoms.