In this weekly series, you get to think like a scientist as we dive into one or two medical journal articles to gain insights into a common health problem. Links to the journal articles are included
In a digital world that provides endless distraction, we tend to focus on things that directly affect us or those we care about. We are drawn to the local news, the posts of our friends, or just tomorrow’s weather forecast. Judged by this standard, for many people, Overactive Bladder (OAB) has that kind of personal impact. Whether we realize it or not, almost all of us know someone well who suffers with OAB (or suffer ourselves). And the impact of these symptoms – financial, social, personal – is immense.
A prior review article by Reynolds et al. is an eye-opening reminder of not only how prevalent OAB is but also what an out-sized impact it has on the lives of those who live with it or care about those who do. The authors note that the development of a precise and easily used definition of OAB based on patient symptoms rather than invasive testing has allowed a better sample of how common OAB really is in the United States. Though there is some variation among the larger studies looking at the prevalence of OAB, it seems likely that around 30% of women and 16% of men report symptoms of urinary frequency or urgency at least some of the time. Up to 11% of women report urinary incontinence associated with OAB. This means that about 37 million women in the United States have overactive bladder with 14 million of them experiencing urinary leakage. To put this in perspective, more people have OAB than diabetes, asthma, or arthritis.
The individual impact of OAB on daily life can be enormous. Much of this effect can be attributed to the embarrassment and distress that urinary leakage can cause. OAB isolates, forcing people to avoid friends, family and many of the activities that they may enjoy. For someone who has to rush to the bathroom every 30 minutes, worshiping at church, seeing a movie with friends, or going to a basketball game is virtually impossible. The authors in this review note studies finding that over 1/3 of people with OAB report their daily activities curtailed by OAB symptoms and 12% even reported staying at home because of their OAB. It is not surprising that many people with OAB gain weight when they are not able to exercise regularly due to their symptoms.
Costs to Society
Even if you don’t personally have overactive bladder or know someone who does (though you almost certainly do), as a society, we pay a very heavy cost for OAB. Overactive bladder costs each of us the equivalent of $426 per year in lost productivity and more than three times that in pads, medications and other treatments. This does not event take into account lost productivity at work. This review cites a study estimating that by 2020, OAB may cost us over $82 billion. That is more than the US government spends on education each year.
For those who personally experience OAB, there is little question of its enormous impact on everyday life. But for the rest of us, there is no denying that overactive bladder should demand our attention.