Qualitative Exploration of the Patient Experience of Underactive Bladder

Eur Urol. 2017 Sep;72(3):402-407. doi: 10.1016/j.eururo.2017.03.045. Epub 2017 Apr 8.

Abstract

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 >30ml (n=34, 77%, median: 199ml) 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.

Keywords: Detrusor underactivity; Patient reported outcomes; Qualitative; Quality of life; Underactive bladder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Aged, 80 and over
  • Cost of Illness*
  • England
  • Female
  • Humans
  • Interpersonal Relations
  • Interviews as Topic
  • Lower Urinary Tract Symptoms / diagnosis
  • Lower Urinary Tract Symptoms / physiopathology*
  • Lower Urinary Tract Symptoms / psychology*
  • Male
  • Middle Aged
  • Nocturia / diagnosis
  • Nocturia / physiopathology
  • Nocturia / psychology
  • Patient Reported Outcome Measures
  • Qualitative Research
  • Quality of Life*
  • Social Behavior
  • Urinary Bladder / physiopathology*
  • Urinary Bladder Diseases / diagnosis
  • Urinary Bladder Diseases / physiopathology*
  • Urinary Bladder Diseases / psychology*
  • Urinary Incontinence / diagnosis
  • Urinary Incontinence / physiopathology
  • Urinary Incontinence / psychology
  • Urinary Retention / diagnosis
  • Urinary Retention / physiopathology
  • Urinary Retention / psychology
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / physiopathology
  • Urinary Tract Infections / psychology
  • Urodynamics