Evidence grows about low number getting medical help for bladder problems

As few as four per cent of US adults with overactive bladders (OAB) seek medical treatment, despite the condition affecting an estimated 34 million Americans over the age of 18, according to research in the March issue of the UK-based urology journal BJU International.

The American research comes hard on the heels of a recent European study, published in the same journal, which reported that only 43 per cent of adults with OAB would consider visiting their doctor.

A team led by Dr Sunny Kim from Florida International University looked at national Government databases covering visits to hospitals and family doctors. They found a large unmet medical need among Americans with OAB, even though it’s one of the 10 most common chronic medical conditions in the country.

The 1.5 million adults included in the American study had an OAB diagnostic code in their records but only a third had it listed as the primary reason for their visit.

“Our study suggests that OAB is greatly-undiagnosed and under-treated in America” says Dr Kim. “16 per cent of the adult population has the condition, but only one in every 25 sufferers actually seeks medical attention.”

“We believe that OAB is commonly under-reported in research because people taking part in studies feel embarrassed about OAB and because of the negative social stigma or shame many associate with the condition.

“This study shows that the number of people actually seeking medical care is much lower than it should be. The databases used in this study were collected by the Center for Disease Control from healthcare providers and should accurately reflect levels of healthcare use in the United States.”

The research covered three leading national databases which are compiled annually:

• The National Ambulatory Medical Care Survey (NAMCS) – covering physicians not employed by Federal authorities who provide office-based care.
• National Hospital Ambulatory Medical Care Survey (NHAMCS) - visits made to emergency and out-patient departments of non-Federal short-stay or general hospitals.
• National Hospital Discharge Survey (NHDS) - inpatients discharged from non-Federal short-stay hospitals.

The first two recorded up to three diagnoses for each episode of care and the third recorded seven. If at least one diagnosis code included an OAB symptom, the visit was identified as an OAB associated episode.

Approximately 95 per cent of the OAB visits came from the statistics provided by the NAMCS, three per cent by the NHAMCS and two per cent from the NHDS.

“Although OAB is more common as people get older, it is not – as many people think - a normal part of the ageing process and could be the result of a treatable medical condition” concludes Dr Kim.

“This common misunderstanding could explain why many people are reluctant to seek professional health for OAB, despite the fact that it can have great social and emotional impact on their lives.

“The unmet medical need identified by our study may increase dramatically in the next 30 years as people live longer and older people make up a larger percentage of the population.

“Greater public awareness of the causes of OAB – and the treatment available - could substantially increase the overall health and quality of life of the large number of people suffering from this condition.”