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Activity Faculty

Charles R. Rardin, MD
Alpert Medical School of Brown University
Providence, Rhode Island


Article Summary

Rengananthan A, Robinson D, Cardozo L, Srikrishna S, Cartwright R. Do women with overactive bladder have realistic expectations for therapy? Int Urogyn J. 2010;21:409-414.


Introduction

The impact of urgency and urge incontinence on quality of life has been well-documented; however, the complicated relationships between therapies, costs and adverse effects, and the objective and subjective tools used to measure lower urinary tract symptoms make definition of “cure” elusive. This study sought to determine what women with overactive bladder perceived as “cure,” and to elucidate the correlation between quality of life impairment and expectations from therapy.


Methods

153 women with bothersome OAB, and without report of stress incontinence, voiding dysfunction or prolapse, were recruited; of note, all patients were treatment-naïve.  Patients filled out the King’s Health Questionnaire (KHQ) as well as a novel questionnaire instrument designed, based on qualitative clinical interviews, to assess patient expectations and attitudes about the following:


Results

Prior to initiation of treatments, the following observations were made:


Expert Opinion

This study helps to understand the low compliance rates observed with anticholinergic use. While 65% of women expected complete cure of incontinence, and 24% expected cure of all symptoms, few anticholinergic trials have demonstrated that level of performance. Perhaps most instructive, though, is the a priori reluctance to accept long-term medication as a treatment strategy. Although there are some limitations to the present study, including the use of a non-validated questionnaire tool and a relatively small sample size, there are insights that are likely to aid the clinician in helping patients develop treatment goals and expectations that are realistic and acceptable.


Article Link

http://www.ncbi.nlm.nih.gov/pubmed/19936590