'OAB-Dry' May Need to be Reassessed

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WASHINGTON, D.C.—Questionnaires used to diagnose patients with overactive bladder (OAB) may identify anyone with polyuria, bladder hypersensitivity, and even OAB-wet with rare leakage episodes as OAB-dry, investigators reported at the American Urological Association 2011 annual meeting.

Jennifer Anger, MD, Assistant Professor of Urology at the David Geffen School of Medicine at the University of California in Los Angeles, and her colleagues found that qualitative data from focus groups and expert interviews suggest that women with OAB-dry may not, in fact, be truly dry. Instead, the researchers found that a spectrum exists between very mild OAB-wet and more severe OAB-wet.

The International Continence Society defines OAB as urinary urgency with or without urge urinary incontinence, usually with frequency and nocturia. Studies have shown that community-based surveys identify up to 70% of OAB patients as “dry.”  Dr. Anger and her colleagues conducted five focus groups with a total of 33 OAB patients (three OAB-wet and two OAB-dry groups).

Non-clinician moderators ran the focus groups and incorporated topics related to patient's perceptions of OAB symptoms, treatment, and outcomes. In addition, the researchers conducted 12 expert interviews in which the interviewees were asked to describe their views on OAB-wet and OAB-dry. The researchers performed a qualitative analysis on verbatim transcriptions and conducted extensive chart reviews. 

The team found it difficult to identify pure OAB-dry patients. Women with OAB-dry reported they will leak if no toilet is available, based on a history of past leakage episodes. Moreover, most women with OAB-dry wore light protective pads. 

Those few patients with no history of leakage had a clinical picture more consistent with bladder hypersensitivity/IC than OAB, the researchers noted. They also observed that physician expert interviews revealed the belief that OAB-dry may be an early, milder form of OAB-wet.

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