Overactive Bladder: the Patient Perspective

Purposeof Review Given that the diagnosis and management of overactive bladder (OAB) is directed by symptomatology, the patient perspective is critical to understanding the disease and efficacy of available treatments. We present a narrative review of literature published in the last 5 years surrounding the patient perspective of OAB. Recent Findings OAB has a negative effect on health-related quality of life (HRQoL). Management of OAB generates significant cost to the patient, including physician visits, incontinence pads, treatment of urinary tract infections, and management of skin infections and irritation. Patients with OAB suffer in terms of work productivity, food insecurity, and financial strain, and these effects are more profound in patients of lower socioeconomic status and education level. Recent literature investigating the effect of β3-adrenergic agonists on patient quality of life demonstrated similar improvements when compared with anticholinergics and potentially greater tolerability in terms of adverse effects. In terms of third-line therapies, sacral neuromodulation (SNM) has been shown to have significant improvement in HRQoL and urinary symptoms while avoiding the need for frequent office visits. Summary OAB can have a detrimental effect on HRQoL, sexual function, work productivity, and can generate significant cost to the patient. Recent literature demonstrates that existing treatments show promise in terms of improving HRQoL. Patients prefer oral medications over injectable or more invasive therapies; however, a majority of patients who fail medications are willing to trial third-line therapies. Continued investigation of the patient perspective on OAB will be paramount to continue improvement in patient care.