Qualitative Exploration of the Patient Experience of Underactive Bladder

Uren, Alan D.; Cotterill, Nikki; Harding, Christopher; Hillary, Christopher; Chapple, Christopher; Klaver, Monique; Bongaerts, Dominique; Hakimi, Zalmai; Abrams, Paul

Abstract

© 2017 European Association of Urology Background Underactive bladder (UAB) is considered the symptom complex associated with the urodynamic diagnosis of detrusor underactivity. Objective The aim of this research was to investigate the patient reported experience of the symptoms, signs, and impact of UAB. This research is also part of the initial qualitative phase for the development of a new patient reported outcome measure for the assessment of UAB. Design, setting, and participants Qualitative methods were used to understand the experience of UAB from a patient perspective, in a purposive sample of male (n = 29) and female (n = 15) patients aged 27–88 yr (mean: 64 yr), diagnosed with a primary diagnosis of detrusor underactivity, with or without coexisting urological conditions. Semistructured interviews were conducted in Bristol, UK. Results Male and female patients reported a variety of lower urinary tract symptoms and associated impact on quality of life. Storage symptoms of nocturia, increased daytime frequency, and urgency, and the voiding symptoms of slow stream, hesitancy, and straining were reported by over half of the patients. A sensation of incomplete emptying and postmicturition dribble were also frequently described. Most had a post void residual >30 ml (n = 34, 77%, median: 199 ml) with many reporting urinary tract infections, a history of self-catheterisation, and some experiencing occasional acute retention episodes. These symptoms and signs can have a broad impact on quality of life including having to plan their daily activities around the location of toilets, disruption to sleep, social life, and associated effect on family and friends. Conclusions Knowledge of the lived experience of UAB obtained in the current study will be used for the development of a new patient reported outcome measure and help inform the current working definition of UAB. Patient summary The symptoms, signs, and impact on quality of life of underactive bladder are described by patients with the condition.

• Journal Article Type: Article
• Acceptance Date: Mar 29, 2017
• Online Publication Date: Apr 8, 2017
• Publication Date: Sep 1, 2017
• Deposit Date: Jul 26, 2018
• Publicly Available Date: Jul 26, 2018
• Journal: European Urology
• Print ISSN: 0302-2838
• Electronic ISSN: 1873-7560
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 72
• Issue: 3
• Pages: 402-407
• DOI: https://doi.org/10.1016/j.eururo.2017.03.045
• Keywords: detrusor under activity, patient reported outcomes, qualitative, quality of life, underactive bladder
• Public URL: https://uwe-repository.worktribe.com/output/882334
• Publisher URL: https://doi.org/10.1016/j.eururo.2017.03.045
• Additional Information: Additional Information : This is the author's accepted manuscript. The final published version is available here: https://doi.org/10.1016/j.eururo.2017.03.045.
• Contract Date: Jul 26, 2018