How does overactive bladder (OAB) affect quality of life?

Updated: Jan 21, 2021
  • Author: Pamela I Ellsworth, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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OAB significantly impairs QoL, increases depression scores, and reduces quality of sleep. OAB that involves urgency incontinence is associated with the most severe impairment. Persons with OAB who have poor sleep quality report chronic fatigue and difficulty performing daily activities. An increased number of hip fractures due to falls in elderly persons have been attributed to OAB because of the nocturia component. Many such falls involve the individual tripping or losing balance while getting out of bed.

Individuals with OAB develop coping strategies to manage or hide their problems (eg, modifying fluid intake, toilet mapping, reduced physical or social activity). These coping strategies, along with the OAB symptoms themselves, commonly affect interactions with friends, colleagues, and families and thereby have an adverse impact on QoL.

Notable psychological effects of OAB and urinary incontinence include fear, shame, and guilt. In elderly people with OAB and incontinence, the need for assistance with toileting, shopping for protective undergarments, and laundry may place an additional burden on family members.

Worries and concerns regarding odor, uncleanliness, and leakage during sexual activity may lead individuals to refrain from intimacy. Frequent urination and the need to interrupt activities may affect the person’s work and ability to travel. Studies of the impact of OAB and urinary incontinence demonstrate decreased levels of social and personal activities, increased psychological distress, and an overall decrease in QoL. [17]

The impact of OAB on QoL is independent of whether the symptoms are associated with urinary incontinence. Studies with the Short Form-36 (SF-36), a generic QoL questionnaire, demonstrated that OAB affects physical functioning, social functioning, vitality, and emotional roles (see the image below). A shortened form of the SF-36, the Short Form-20 (SF-20), is another reliable and valid instrument for measuring health-related QoL. [23]

Overactive bladder (OAB) and quality of life (QoL). Short Form-36 (SF-36). Reprinted with permission from Blackwell.

Overactive bladder (OAB) and quality of life (QoL) Overactive bladder (OAB) and quality of life (QoL). Short Form-36 (SF-36). Reprinted with permission from Blackwell.

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