Would screening for overactive bladder improve diagnosis rates?

Nov 27, 2018
Would screening for overactive bladder improve diagnosis rates?

Screening for overactive bladder may help increase diagnosis rates by raising awareness and overcoming the embarrassment factor.

In the US alone, 33 million people, around 16% of the nation’s population, have symptoms associated with overactive bladder (OAB).1 It’s a problem that can impact on quality of life, yet it carries a stigma that can stop people from asking for the help they need.2

New guidelines have recommended all women be screened for urinary incontinence annually.3

“Despite its high rates and adverse effects on health, well-being, and function, urinary incontinence is underreported by women and therefore infrequently recognized by clinicians,” said the Women’s Preventative Services Initiative (WPSI) group’s clinical guidelines, published in the Annals of Internal Medicine in September.

“In a survey, approximately 55% of women with urinary incontinence did not report symptoms to their healthcare providers because of embarrassment, stigma, or acceptance as normal.”

Speaking to Change Together ahead of Bladder Health Month, urologist Dr. Ekene Enemchukwu, agreed with the guidance, adding that the awareness campaign was an important part of the solution to low diagnosis rates.

“However, as long as primary care providers are the gatekeepers, there will be some challenges in improving diagnosis and treatment rates. This is because of the lack of time and a general focus on other health-related issues such as blood pressure, cholesterol, and diabetes risk assessment competing comorbidities,” she said.

“Screening programs have been very successful for conditions like prostate and breast cancer. A campaign that emphasizes screening for OAB or incontinence at a certain age would eliminate the issue with embarrassment and lack of time.”

She suggested the use of a five-question standardized questionnaire, adding that obstetrician-gynecologist clinics “would be a great place to start, though it would exclude men.”

Anything that encourages women to start a dialogue around incontinence issues should be welcomed, said the National Association for Continence (NAFC).

“Incontinence is not just a condition of the elderly and certainly is not just something anyone should just live with,” said Steven G. Gregg, Ph.D., Executive Director of NAFC. “There are a number of underlying causes but most importantly there are treatment options available.”

“The key to success for the treatment of bladder control problems is to first get an accurate diagnosis,” he said.

A healthcare professional raising the issue would help people living with incontinence understand that this is a treatable medical condition that is neither inevitable nor embarrassing, Gregg added.

The WPSI advice said that screening had “the potential to identify urinary incontinence in many women who silently experience its adverse effects.”

Early intervention may reduce symptom progression, improve quality of life, and limit the need for more complex and costly treatment, it added.


References

  1. Urology Care Foundation (2018). Overactive bladder: Introduction. Available from: http://www.urologyhealth.org/overactive-bladder (accessed October 2018)
  2. Urology Care Foundation (2018). Get the facts, get diagnosed and take control of your bladder health. Available from: http://www.urologyhealth.org/media-center/press-releases/november-is-bladder-health-awareness-month (accessed October 2018)
  3. O’Reilly N, Nelson HD, Conry JM, Frost J, Gregory KD, et al.; Women’s Preventive Services Initiative. Screening for Urinary Incontinence in Women: A Recommendation From the Women’s Preventive Services Initiative. Ann Intern Med 2018; 169:320-328.
Would screening for overactive bladder improve diagnosis rates?

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