Risk Factors For Overactive Bladder Research Articles

Association between Menopausal Symptoms and Overactive Bladder: A Cross-Sectional Questionnaire Survey in China.

PurposeThe association between menopause and overactive bladder is controversial. The purpose of this study was to determine the association between menopausal symptoms and overactive bladder, and identify the risk factors for overactive bladder.MethodsA cross-sectional study was performed. The study included 403 women aged 36–76 years who visited the menopause clinic at Peking University First Hospital between September 2012 and December 2013. The overactive bladder symptom score and modified Kupperman index questionnaires were used. Differences were assessed using descriptive statistics to determine any association between the overactive bladder symptom score and modified Kupperman index score, and to evaluate the risk factors for overactive bladder.ResultsA total of 304 women were finally enrolled. The prevalence of overactive bladder was 9.43%, and the modified Kupperman index score; number of sexual problems; and frequency of urinary tract infections, vertigo, melancholia, and mood swings were significantly higher in patients with overactive bladder than in the patients without overactive bladder (p < 0.05). Menopausal symptoms (modified Kupperman index score ≥ 15) (odds ratio: 1.049, 95% confidence interval: 1.006–1.095, p = 0.025) and a low frequency of sexual intercourse in the last 6 months (odds ratio: 2.580, 95% confidence interval: 1.228–5.422, p = 0.012) were identified as independent risk factors for overactive bladder. The frequency of sexual intercourse was found to decrease with an increase in the severity of overactive bladder (p = 0.004, linear-by-linear association = 0.001).ConclusionMenopausal symptoms may be closely associated with overactive bladder, and sexual activity may be associated with the severity of overactive bladder. Moreover, sexual problems, urinary tract infections, vertigo, melancholia, and mood swings may be associated with overactive bladder.

Symptoms, prevalence, and risk factors of overactive bladder in women in south India

Symptoms, prevalence, and risk factors of overactive bladder in women in south India

OAB epidemiological survey of general gynaecology outpatients and its effects on patient quality of life.

To survey the prevalence rate of overactive bladder (OAB) among general gynaecology outpatients, it's connection to common benign gynaecological diseases and its effects on patient quality of life (QOL). A questionnaire survey on urination and its effects on QOL was administered to 2500 general gynaecology outpatients aged ≥18 who visited our hospital which is in Peking between October and November 2012. Additionally, their menstrual history and diseases were documented, according to their medical records. In total, 2161 effective questionnaires (86.4%) were collected from the respondents, who were aged 18-97 years. The overall OAB prevalence rate was 8.8% (191/2161), and the OAB prevalence rate in women >50 years was significantly higher (X(2) = 7.656, P < 0.05). Moreover, the OAB prevalence rate (25.8%) among patients suffering from pelvic organ prolapse was significantly higher than the rate (8.6%) among patients without pelvic organ prolapse (X(2) = 11.238, P < 0.05). Multi-factor logistic regression indicated that age (OR = 1.504, 95% CI = 1.072-2.111) and pelvic organ prolapse (OR = 2.512, 95% CI = 1.109-5.688) were risk factors for OAB among the respondents. Additionally, with the rise of OAB severity, its effects on the QOL of OAB patients, like urinary urgency, nocturia, frequency and urge incontinence increased accordingly. The OAB prevalence rate among general gynaecology outpatients was 8.8%, and the effects of OAB on QOL increased with the worsening of the disease.

Soluble Guanylyl Cyclase (sGC) Degradation and Impairment of Nitric Oxide-Mediated Responses in Urethra from Obese Mice: Reversal by the sGC Activator BAY 60-2770

Obesity has emerged as a major contributing risk factor for overactive bladder (OAB), but no study examined urethral smooth muscle (USM) dysfunction as a predisposing factor to obesity-induced OAB. This study investigated the USM relaxant machinery in obese mice and whether soluble guanylyl cyclase (sGC) activation with BAY 60-2770 [acid 4-({(4-carboxybutyl) [2-(5-fluoro-2-{[4-(trifluoromethyl) biphenyl-4-yl] methoxy} phenyl) ethyl] amino} methyl) benzoic] rescues the urethral reactivity through improvement of sGC-cGMP (cyclic guanosine monophosphate) signaling. Male C57BL/6 mice were fed for 12 weeks with a high-fat diet to induce obesity. Separate groups of animals were treated with BAY 60-2770 (1 mg/kg per day for 2 weeks). Functional assays and measurements of cGMP, reactive-oxygen species (ROS), and sGC protein expression in USM were determined. USM relaxations induced by NO (acidified sodium nitrite), NO donors (S-nitrosoglutathione and glyceryl trinitrate), and BAY 41-2272 [5-cyclopropyl-2-[1-(2-fluoro-benzyl)-1H-pyrazolo[3,4-b]pyridin-3-yl]-pyrimidin-4-ylamine] (sGC stimulator) were markedly reduced in obese compared with lean mice. In contrast, USM relaxations induced by BAY 60-2770 (sGC activator) were 43% greater in obese mice (P < 0.05), which was accompanied by increases in cGMP levels. Oxidation of sGC with ODQ [1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one] (10 μM) potentiated BAY 60-2770-induced USM responses in the lean group. Long-term oral BAY 60-2770 administration fully prevented the impairment of USM relaxations in obese mice. Reactive-oxygen species (ROS) production was enhanced, but protein expression of β1 second guanylate cyclase subunit was reduced in USM from obese mice, both of which were restored by BAY 60-2770 treatment. In conclusion, impaired USM relaxation in obese mice is associated with ROS generation and down-regulation of sGC-cGMP signaling. Prevention of sGC degradation by BAY 60-2770 ameliorates the impairment of urethral relaxations in obese mice.

The prevalence and risk factors of OAB in middle‐aged and old people in China

To evaluate the prevalence of associated risk factors of over active bladder (OAB) in people ≥40 years old in mainland of China. A randomized community-based, cross-sectional study was performed on 10,160 residents (≥40 years old) in the mainland of China using a questionnaire. The overactive bladder symptom score (OABSS) was filled upon site. The chi-square test was used to determine the differences of prevalence between sex, age groups, body mass index (BMI) and people with and without diabetes mellitus (DM). A total of 9,805 (96.5%) subjects qualified for the final statistical analysis. The overall prevalence of OAB was 2.1% (209/9,805), of whom 1.0% had OABdry and 1.1% had OABwet . The prevalence of OAB was more common in men than in women over the age of 60 (4.6% vs. 2.6%, P < 0.05). The prevalence of OAB in subjects with DM was significantly higher than those without DM in patients with BMI ≥ 25 (P < 0.05). The subjects with a BMI over 29 were more likely to have OAB (3.2% vs. 1.8%, P < 0.05). In this population, the prevalence of OAB increased with age for both sexes, but was higher for males over 60 years of age. The study also showed that diabetics with BMI ≥ 25 and people suffering from obesity are more likely to have OAB.

Depression, Anxiety and the Bladder.

Depression and anxiety are common mental illnesses. It is recognized that depression/anxiety causes physical changes, including insomnia, anorexia, and bladder dysfunction. We aimed to delineate bladder dysfunction in patients with depression/anxiety by reviewing the literature. We performed a systematic review of the literature to identify the frequency, lower urinary tract symptoms (LUTS), urodynamic findings, putative underlying pathology, and management of bladder dysfunction in patients with depression/anxiety. From a recent survey of a depression cohort (at a psychiatry clinic), the frequency of bladder dysfunction in depression is lower (up to 25.9%) than that in Parkinson's disease (up to 75%) and stroke (up to 55%), whereas it is significantly higher than that in age-matched controls (around 10%). In both the depression cohort and the psychogenic bladder dysfunction cohort (at a urology clinic), the most common LUTS was overactive bladder (OAB), followed by difficult urination and infrequent voiding. Compared with severe LUTS, urodynamic findings were dissociated; i.e. urodynamic findings were normal except for increased bladder sensation without detrusor overactivity for OAB (50% of all patients), followed by underactive detrusor without post-void residual for difficult urination. The effectiveness of serotonergic or anti-cholinergic medication for ameliorating OAB in the patients awaits further study. In conclusion, although the frequency of LUTS among the depression cohort is not elevated, depression/anxiety is obviously a risk factor for OAB. This finding presumably reflects that the bladder is under emotional control. Amelioration of bladder dysfunction is an important target in treating patients with depression/anxiety.

Prevalence and risk factors of overactive bladder in middle-aged and senior people

Objective To study the prevalence,risk factors of overactive bladder (OAB) in middle-aged and senior residents in Zhengzhou China.Methods A randomized,community-based,crosssectional study was performed on 10 160 residents aged 40 or older in urban area of Zhengzhou by using a stratified system sampling approach.A questionnaire including the subjects' basic information,previous history,present history,the Chinese overactive bladder symptom score (OABSS) was filled on site.The diagnostic criteria for OAB was 'an urgency score for Question 3 of 2 or more,and an OABSS of 3 or more'.Chisquare test was used to determine the differences of prevalence between genders,age groups,BMI and people with and without diabetes mellitus (DM).A pairwise comparison was conducted between different age,BMI group by using Bonferroni method.Results A total of 10 160 residents were investigated and finally 9805 (96.5％) were qualified for final statistical analysis.The mean age was (57.9 ± 9.7) years.The overall prevalence of OAB was 2.1％ (209/9805),of which,with OABdry 1.0％,and OABwet 1.1％.Male subjects were more likely suffered from OAB than female,with 2.7％ (84/3129) versus 1.9％ (125/6676).The prevalence of OAB in both male and female increased with age.There was no significant difference in the prevalence of male and female before the age of 60 years (1.2％ versus 1.4％,P ＞ 0.05) and more common in men than in women after the age of 60 years (4.6％ versus 2.6％,P ＜ 0.05).The prevalence of the subjects with DM was significantly higher than those without DM (P ＜ 0.05).The subjects with BMIs of 30 or more were nore likely to have OAB (3.2％ versus 1.8％,P ＜ 0.05).Conclusions The prevalence of OAB increases with advancing age.The prevalence of male is higher than female after the age of 60 years.The diabetics and obese people are more likely to have OAB. Key words: Overactive bladder; Overactive bladder symptom score; Diabetes mellitus; Epidemiology; Middle-aged people

Role of PKC and CaV1.2 in detrusor overactivity in a model of obesity associated with insulin resistance in mice.

Obesity/metabolic syndrome are common risk factors for overactive bladder. This study aimed to investigate the functional and molecular changes of detrusor smooth muscle (DSM) in high-fat insulin resistant obese mice, focusing on the role of protein kinase C (PKC) and Cav1.2 in causing bladder dysfunction. Male C57BL/6 mice were fed with high-fat diet for 10 weeks. In vitro functional responses and cystometry, as well as PKC and Cav1.2 expression in bladder were evaluated. Obese mice exhibited higher body weight, epididymal fat mass, fasting glucose and insulin resistance. Carbachol (0.001–100 µM), α,β-methylene ATP (1–10 µM), KCl (1–300 mM), extracellular Ca2+ (0.01–100 mM) and phorbol-12,13-dibutyrate (PDBu; 0.001–3 µM) all produced greater DSM contractions in obese mice, which were fully reversed by the Cav1.2 blocker amlodipine. Cystometry evidenced augmented frequency, non-void contractions and post-void pressure in obese mice that were also prevented by amlodipine. Metformin treatment improved the insulin sensitivity, and normalized the in vitro bladder hypercontractility and cystometric dysfunction in obese mice. The PKC inhibitor GF109203X (1 µM) also reduced the carbachol induced contractions. PKC protein expression was markedly higher in bladder tissues from obese mice, which was normalized by metformin treatment. The Cav1.2 channel protein expression was not modified in any experimental group. Our findings show that Cav1.2 blockade and improvement of insulin sensitization restores the enhanced PKC protein expression in bladder tissues and normalizes the overactive detrusor. It is likely that insulin resistance importantly contributes for the pathophysiology of this urological disorder in obese mice.

Burden of overactive bladder symptom on quality of life in stroke patients

Overactive bladder (OAB) affects the daily life of many stroke victims. In contrast to urinary incontinence, little is known about the prevalence and risk factors for OAB among stroke patients. Therefore, we conducted a questionnaire survey and analyzed the results together with the clinical data and MRI findings. A total of 500 volunteer patients with chronic-phase stroke were enrolled. The overactive bladder symptom score (OABSS), Short Form 8 (SF-8) health survey questionnaire, and some key international questionnaires about urinary dysfunction were assessed. We diagnosed 141 patients (28%) with OAB, among whom 103 (73%) had never been treated for their symptoms. Patients with OAB showed lower scores in both the physical and mental components of the SF-8, which suggested the burden of OAB on the quality of life of stroke patients. Advanced age and male gender were closely related to high OABSS. The modified Rankin Scale (mRS) was positively correlated with OABSS. Patients with cerebral infarction and those with intracerebral hemorrhage showed a similarly high OABSS. The severity of deep white-matter hyperintensity on MRI, classified by the 4-grade Fazekas scoring system, was significantly associated with high OABSS irrespective of presence of accompanying infarcts. Patients with cerebral infarcts in the region of anterior circulation showed a higher OABSS than those with cerebral infarcts in the posterior circulation. Based on the present risk analysis, patient care should be preferentially focused on the detection and treatment of OAB to improve the quality of life of stroke patients.

The prevalence of probable overactive bladder, associated risk factors and its effect on quality of life among Turkish midwifery students

To evaluate the associated risk factors of probable overactive bladder (OAB) and to determine the effect of OAB on quality of life through validated questionnaires in Turkish midwifery students. 279 midwifery students were invited to participate, and 265 (95.0%) were included in the study, which was approved by the local ethics committees. The relationship between quality of life and probable OAB was evaluated using Turkish language-validated questionnaires (OABq SF, NQOL). Chi-square test, t-test and logistic regression were used for the statistical analysis, and p<0.05 was considered significant. The participants' mean age was 21.74 ± 2.15 years. The prevalence of OAB was 35.4%. There was a significant relationship between the presence of probable OAB and familial urinary incontinence history and childhood nocturnal enuresis. In the logistic regression analysis, family history was associated with an OR of 2.11 (95% CI: 1.08-4.10) for OAB, and nocturia with an OR of 2.69 (95% CI: 1.16-6.21) for OAB. Drinking moderate amounts of tea and carbonated drinks daily did not affect OAB, but extreme consumption of these beverages was associated with an OR of 2.98 (95% CI: 1.26-7.03) for OAB. OAB significantly worsens quality of life according to all the quality of life indices. OAB is not a rare condition among young people. It appears that the quality of life was adversely influenced by OAB among both younger and older people. Familial urinary incontinence and childhood nocturnal enuresis were found to be risk factors for OAB. There is insufficient evidence to restrict tea or carbonated drinks consumption in young people with OAB unless their consumption is extreme.

The Presence of Overactive Bladder Wet Increased the Risk and Severity of Erectile Dysfunction in Men with Type 2 Diabetes

Diabetes is a common risk factor for overactive bladder (OAB) syndrome and erectile dysfunction (ED). The study evaluated the risk factors of OAB and association of OAB and ED in type 2 diabetic men. The diagnosis of ED and OAB was based on a self-administered questionnaire containing Sexual Health Inventory for Men (SHIM) and OAB symptom score (OABSS, 0-15, indicating increasing severity of symptoms), respectively. The clinical variables and diabetes-associated complications, including ED, which are risk factors for OAB, were evaluated. Of 453 consecutive subjects attending outpatient diabetic clinic with a mean age of 60.6 years, 25.4%, 10.2%, 81.9%, and 28.3% reported having OAB, OAB wet, ED, and severe ED, respectively. The OABSS is inversely associated with SHIM (correlation coefficient-0.275). The patients with OAB have significantly lower SHIM score, testosterone level, and serum albumin level, have more proportion of severe ED, were older, and have longer duration of diabetes mellitus (DM). After adjustment for age and duration of DM, the presence of severe ED was associated with OAB (odds ratio [OR] = 1.58), and severe ED (OR = 2.36), SHIM score (OR = 0.92), and serum albumin level (OR = 0.24) were risk factors for OAB wet (patients with urgency incontinence, once a week or more). The OR of ED in patients with OAB or OAB wet compared with no OAB was 1.82, and 3.61, respectively. Among the OAB components, urgency incontinence has the strongest impact on ED (OR = 4.06), followed by nocturia, urgency, and frequency. About 15.1% (N = 68) without OAB and ED are younger and have shorter DM duration, lower systolic BP, and higher serum albumin level after multivariate analysis compared with patients with OAB or ED. The presence of severe ED was significantly associated with OAB, especially OAB wet. The presence of OAB wet increased the risk and severity of ED.

Association Between Metabolic Syndrome and Male Overactive Bladder in a Japanese Population Based on Three Different Sets of Criteria for Metabolic Syndrome and the Overactive Bladder Symptom Score

To investigate whether metabolic syndrome is a risk factor for overactive bladder (OAB) defined by the Overactive Bladder Symptom Score (OABSS). A digital rectal examination of the prostate and an OABSS questionnaire were conducted in 1031 men who visited our hospital for metabolic screening from April 2009 to March 2010. The OABSS includes scores for daytime frequency, nighttime frequency, urgency, and urgency incontinence. Relationships of OAB (defined as OABSS ≥3 with an urgency score ≥2) with metabolic syndrome diagnosed by Japan Society for the Study of Obesity (JASSO), National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), and International Diabetes Federation (IDF) criteria were examined. The severity of OAB symptoms was compared among younger, middle-aged, and elderly men (<50, 50-64, and ≥65 years old, respectively) with and without metabolic syndrome. Diagnoses of metabolic syndrome were made in 16.4%, 16.9%, and 12.0% of the men using JASSO, NCEP-ATP III, and IDF criteria, respectively. Regardless of the presence of metabolic syndrome, aging was significantly associated with increased rates of moderate or severe OABSS findings and OAB defined by the OABSS. In middle-aged men, metabolic syndrome had a significant negative association with OAB rate. In elderly men, metabolic syndrome had a significant negative association with the total OABSS. A relationship between age and OAB was observed, but metabolic syndrome did not show a clear association with OAB. Our results suggest that OAB is associated with aging regardless of the presence of metabolic syndrome.

Analysis of the Risk Factors for Overactive Bladder on the Basis of a Survey in the Community

PurposeTo evaluate the risk factors for overactive bladder (OAB) in a population aged 40 years and over in the community.Materials and MethodsWe conducted a community-based survey of OAB in a population aged 40 years and over in Guri City and Yangpyeong County, South Korea, by use of the overactive bladder symptom score (OABSS) questionnaire. A total of 926 subjects were included in the final analysis. The definition of OAB was more than 2 points for the urgency score and 3 points for the sum of scores. In addition, the subjects were asked about age, dwelling place, marital status, educational status, behavioral factors (smoking, drinking, etc), and medical history. Categorical variables were analyzed by using the logistic regression model and were adjusted for age by using the logistic regression model.ResultsOverall OAB prevalence was 14.1% (130/926), made up of 49/403 males (12.2%) and 81/523 females (15.5%). OAB prevalence increased with age (p<0.0001). Risk factors for OAB were educational status (age-adjusted p=0.0487), stroke (p=0.0414), osteoporosis (p=0.0208), asthma (p=0.0091), rhinitis (p=0.0008), and cataract. Other factors (dwelling place, marital status, smoking, drinking, hypertension, diabetes, hyperlipidemia, myocardial infarction, angina, tuberculosis, atopic dermatitis, hepatitis B, and depression) were not associated with OAB.ConclusionsThe prevalence of OAB in our study was about 14.1% and the risk factors for OAB were educational status, stroke, osteoporosis, asthma, rhinitis, and cataract. Knowledge of these risk factors may help in the diagnosis and treatment of OAB.

Risk factors for overactive bladder in the elderly population: A community‐based study with face‐to‐face interview

The aim of this study was to measure the prevalence of and risk factors for overactive bladder (OAB) in the elderly. A cross-sectional study of elderly subjects was conducted by analyzing data from a community-based Comprehensive Geriatric Assessment on people aged 70 years or older. Trained interviewers performed face-to-face interviews for the assessment of urological symptoms. OAB definition was based on urgency and eight or more episodes of urination per day. The subjects completed a self-administered questionnaire including lifestyle evaluation, Geriatric Depression Scale, Mini-Mental Status Examination and medical history. Brachial-ankle pulse wave velocity was recorded to assess atherosclerotic disease. The analysis included 833 subjects, after the exclusion of 115 subjects who provided insufficient information. Based on the definition of OAB, 153 subjects (18.4%) were identified as having OAB. Univariate analysis showed a significant association between OAB and depressive symptoms. Multivariate analysis showed that the risk of having OAB was significantly higher in subjects with depressive symptoms, current drinkers, and overweight subjects with odds ratios of 2.37 (1.60-3.52, 95% confidence interval), 1.65 (1.04-2.62), and 1.51 (1.02-2.24), respectively. This is the first report to show an association between OAB and depressive symptoms and alcohol intake in an epidemiological study of elderly people. The reasons for these correlations remain unclear, but should be the foci of future OAB studies.

The prevalence and risk factors of overactive bladder symptoms and its relation to pelvic organ prolapse symptoms in a general female population

Introduction and hypothesisTo study the prevalence and risk factors of overactive bladder (OAB) symptoms and its relationship with symptoms of pelvic organ prolapse (POP).MethodsThis is a cross-sectional study including women aged between 45 and 85 years, registered in eight general practices. All women were asked to self complete the validated Dutch translated questionnaires. All symptoms were dichotomized as present or absent based on responses to each symptom and degree of bother.ResultsForty-seven percent of the women filled out the questionnaire. Prevalence of urgency was 34% and the prevalence of any OAB symptoms 49%. Prevalence of OAB symptoms increased with advancing age. Symptoms of POP were an independent risk factor for symptomatic OAB. Other risk factors were continence and prolapse surgery in the past, age above 75, overweight, postmenopausal status and smoking.ConclusionsThe prevalence of any OAB symptoms was 49%. POP symptoms were an independent risk factor for symptomatic OAB.

Obesity and urinary incontinence in women: is the black box becoming grayer?

The prevalence of obesity is increasing worldwide and has lately reached epidemic proportions in many countries. Epidemiological studies have consistently shown that both overweight and obesity are important risk factors for the development of various female pelvic floor disorders including urinary incontinence, pelvic organ prolapse, and fecal incontinence, as well as resistance to treatment [1]. The relationship between obesity and urinary incontinence will be discussed here. Strong associations between obesity and stress urinary incontinence (SUI) in women had been frequently reported in the urogynecologic literature [1, 2]. The pathophysiologic basis for this relationship is the significant correlation between body mass index (BMI) and intra-abdominal pressure suggesting that obesity may stress the pelvic floor secondary to a chronic state of increased pressure [2]. Obesity has also been confirmed as an important risk factor for failure of continence surgery in the first follow-up year. Patients with BMI>30 were 3.7 times more likely to be incontinent 1 year after colposuspension compared to nonobese patients [1]. Weight loss has been proven to be an effective treatment of SUI in obese women. Weight reduction of only 5% of initial body weight has been shown to reduce UI severity enough to result in significant improvement in quality of life measures in obese women [3]. Moreover, surgically induced weight loss had been shown to significantly improve various urodynamic and bladder/urethral imaging parameters during coughing, e.g., the magnitude of vesical pressure increase, bladder-tourethra pressure transmission, and urethral axial mobility. More recently, overweight and obesity were found to be an independent risk factor for overactive bladder (OAB) in women [4]. The most likely explanation is the occurrence of chronic low-grade inflammation in the bladder of obese women indicated by increased urinary chemokines [5]. In fact, dietinduced obesity was shown to be associated with infiltration of macrophages into adipose tissue [6]. Adipocytes surrounding the human bladder can be affected, thus leading to inflammation and triggering OAB symptoms. The waist–hip ratio has been advocated as a measure of “central” obesity because BMI does not describe the distribution of obesity. This measurement, however, was found to be associated with SUI but not with OAB or mixed urinary incontinence, further suggesting a nonmechanical mechanism for OAB in obese women [7]. The association between urinary incontinence and diabetes mellitus, a disease that is closely linked to obesity, is well established [1, 2]. It has been suggested that the most likely reason for the increased risk is a microvascular compromise in diabetic women leading to damage to the urethral sphincter mechanism and bladder “sensitivity” with increased risk of developing SUI and OAB, respectively. Stricter glycemic control may reduce the risk or severity of urinary incontinence [2]. Some studies have also found that women who used insulin were more likely to be incontinent than women who did not require insulin, but the mechanisms are unclear. W. Agur (*) Department of Obstetrics and Gynecology, Crosshouse Hospital, Kilmarnock, Scotland, UK e-mail: waelagur@nhs.net

Prevalence of overactive bladder and the impact of overactive bladder on quality of life in Beijing adult women

Objective To evaluate the prevalence, associated risk factors and the impact on health related quality of life of overactive bladder (OAB) syndrome in Beijing adult women. Methods In the Community-based, cross-sectional study, 2973 women aged over 18 years who lived in urban and suburban communities respectively in Beijing were interviewed through Voiding Function Questionnaire, using a stratified system sampling approach. The women meeting the diagnostic criteria of OAB using the International Continence Society (ICS) definition were further interviewed through King's health questionnaire(KHQ) to estimate the impact of OAB on health related quality of life in Beijing adult women. Results A total of 2379(80.0%) women with complete data were included in this study. The overall prevalence of OAB was 4.7% (112/2379)and demonstrated an significant increasing with advancing age (P＜0.01). The prevalence of OAB was 2.0% in urban and 8. 1 % in suburban. In multiple logistic models, age, BMI, region of residence and anxiety level were associated risk factors for OAB. The result of King's health questionnaire showed the symptoms of OAB affect general health perception and sleep and energy severely. Conclusions The prevalence of OAB in Bei-jing adult women is 4.7%, lower than that of most reports in Occidental women, increases with advancing age, higher BMI and higher anxiety level, and is higher in suburban than in urban. The symptoms of OAB have a detrimental effect on quality of life. Key words: Overactive bladder; Epidemiologic studies; Quality of life

Prevalence and riks factors of overactive Bladder in 6–13 year old korean Children: Nationwide Multicenter Study

PURPOSE To estimate the prevalence of overactive bladder (OAB) with and without nocturnal enuresis (NE), and to asses the relating factors of OAB in Korea. MATERIAL AND METHODS A randomly selected cross sectional study was conducted in 27 kindergartens and 28 elementary schools (16,516 children: 6–13 years). The questionnaires included items about the OAB and NE. OAB was defined as urgency with or without urge incontinence, usually with increased daytime frequency and nocturia (group A) or increased daytime frequency (>8 times/day) and/or urge urinary incontinence (group B). RESULTS The overall prevalence of OAB was 16.59 % (group A) and 18.79% (group B). In group A and B, prevalence of OAB was decreased with age from 22.99% to 12.16% and from 40.44% to 9.60%, respectively (p = 0.0001). Compared to normal, children with OAB had a higher prevalence of NE (p = 0.0001), constipation (p = 0.002), fecal incontinence (p = 0.0001) and history of urinary tract infection (p = 0.001), and a statistically insignificant relation with delayed bladder control, toilet type, parent's scholarship, double-income family and amount of income. Increased daytime frequency and urge incontinence in group A and normal children,were 3.69%, 2.31% (p = 0.009), and 26.97%, 14.78% (p = 0.0001), respectively. Prevalences of increased daytime frequency and urge incontinence in group A were decreased with age from 5.04% to 3.06% and from 45.74% to 18.50%, respectively (p = 0.0001). CONCLUSIONS The overall prevalence of OAB in group A in Korean children was similar to that in group B. NE, constipation, fecal incontinence and history of urinary tract infection may be risk factors of OAB.

The Prevalence and Risk Factors of Overactive Bladder in Korean Children: A Comparative Analysis according to Definition

Jae Min Chung, Sang Don Lee, Dong Il Kang, Dong Deuk Kwon, Kun Suk Kim, Su Yung Kim, Han Gwun Kim, Du Geon Moon, Kwan Hyun Park, Yong Hoon Park, Ki Soo Pai, Hong Jin Suh, Jung Won Lee, Won Yeol Cho, Tae Sun Ha, Sang Won Han, Byung Mann Cho, The Korean Enuresis Association From the Department of Urology, Kosin University College of Medicine, College of Medicine, Pusan National University, Inje University College of Medicine, Busan, Chonnam National University College of Medicine, University of Ulsan College of Medicine, Seoul, Department of Pediatrics and Adolescent Medicine, College of Medicine, Pusan National University, Busan, Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea University College of Medicine, Sungkyunkwan University School of Medicine, Seoul, Department of Pediatrics and Adolescent Medicine, Yeungnam University College of Medicine, Daegu, Department of Pediatrics and Adolescent Medicine, Ajou University School of Medicine, Suwon, Department of Urology, The Catholic University of Korea College of Medicine, Department of Pediatrics and Adolescent Medicine, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Department of Urology, College of Medicine, Dong-A University, Busan, Department of Pediatrics and Adolescent Medicine, Chungbuk National University, Cheongju, Department of Urology, Yonsei University College of Medicine, Seoul, Department of Preventive Medicine, College of Medicine, Pusan National University, Busan, Korea

Behavioral Therapies for Overactive Bladder

Overactive bladder (OAB) is a symptom-based syndrome characterized by the presence of urgency, which is defined as a sudden and compelling desire to void that cannot be postponed. OAB may significantly impact of quality of life. Numerous treatment options exist for OAB, including behavioral therapies such as pelvic floor muscle rehabilitation, bladder training, and dietary modification, as well as traditional therapies such as pharmacological therapy and neuromodulation. Behavioral therapies are considered the mainstay of treatment for urinary incontinence in general. However the efficacy of these noninvasive strategies for OAB treatment has not been well addressed in the literature. This article presents an overview of current evidence with attention to the clinical relevance of findings related to lifestyle modification, bladder training, and pelvic floor muscle training. Initial evidence suggests that obesity, smoking, and consumption of carbonated drinks are risk factors for OAB but there is less support for the contributory role of caffeine or the impact of caffeine reduction. The evidence supporting bladder training and pelvic floor muscle training is more consistent and a trend towards combining these therapies to treat OAB appears positive. Given the prevalence of OAB and growing support for the efficacy of behavioral treatments it is important and timely to augment existing evidence with well-designed multicenter trials.