Patients experiencing overactive bladder (OAB) may feel not just a need to urinate many times in a given day, but may potentially encounter urinary incontinence as well. These symptoms create considerable stress and embarrassment for patients, and can significantly affect their quality of life in severe cases. It has been estimated that up to 30% of men and 40% of women in the US experience OAB symptoms.¹
If a patient is experiencing symptoms or is otherwise concerned about OAB, it may be worth discussing potential risk factors with them. What are some risk factors for OAB you may want to share with your patients?
Age
While being older does not guarantee OAB symptoms, older age does correlate with the likelihood of experiencing them. This is due in part to being at higher risk of other conditions as you age, such as diabetes, enlarged prostate, or neurocognitive disorders.²
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Studies on the subject have corroborated that age is seen as a general risk factor for OAB. A 2018 study published in Obstetrics & Gynecology Science examined the risk factors for OAB and symptom severity using data from Korean women utilizing public health centers.³ Of the participants, 19.3% had been diagnosed with overactive bladder. When broken down into age demographics, the older participants had significantly higher rates of OAB; while just 8.4% of participants under 30 and 10.3% of those in their 30s, respectively, had OAB, it was found in 69.2% of those over 70. Older patients were also much more likely to have moderate or severe OAB symptoms.
Smoking
Another factor the researchers found to be consistently associated with increased risk of OAB was smoking. Current smokers, per the investigators’ data, had as much as three times more frequent urination than non-smokers.
Other studies have yielded similar results. In 2020, a study in the International Journal of Urology focused on the link between smoking and OAB symptoms, specifically the correlation between smoking and lower urinary tract symptoms.⁴ In a survey of 4,756 participants that included 990 former smokers and 938 current smokers, both groups had significantly higher OAB scores than non-smokers. Current smokers had higher prevalence than former smokers, particularly in participants aged 20 to 29. This included a greater likelihood of increased daytime frequency of urination, nocturia, and urgency urinary incontinence.
Urinary Tract Infections
Patients with a urinary tract infection (UTI) may be more likely to experience symptoms of overactive bladder. In addition, a history of UTIs may increase the likelihood of OAB symptoms. A 2019 study in Neurourology and Urodynamics investigated risk factors involved in OAB prevalence among Chinese children aged 5 to 14 and found that a history of UTIs, as well as a personal and family history of lower urinary tract symptoms, were associated with OAB.⁵
Caffeine and Alcohol
Consuming substances that are seen as bladder irritants can potentially trigger symptoms, especially if consumed in large enough quantities. This includes caffeine and alcohol as possible OAB triggers. Patients may benefit from cutting down on their usual caffeine and alcohol consumption to see how it may affect their urinary habits and overall health.
Cardiovascular and Renal Disease
Having cardiovascular or renal disease may play a role in the risk of OAB symptoms. They were identified as notable risk factors for OAB in the aforementioned Obstetrics & Gynecology Science study, renal disease having been singled out in particular.³ The researchers examined renal disease due to data suggesting there is an increase in nocturia in patients with chronic kidney disease. The investigators found cardiovascular and renal disease to each be a significant risk factor among participants with OAB.
Cardiovascular and renal disease may also increase the risk for OAB because they often correlate with other conditions that may trigger symptoms. Cardiovascular disease is often linked to being overweight, which is an OAB risk factor. Cardiovascular disease risk also increases with age. Meanwhile, significant alcohol consumption can affect renal function. Smoking can put patients at risk for both cardiovascular and renal disease.
Patients who are concerned about their overactive bladder symptoms may not be aware of the various ways all of these factors can trigger OAB symptoms, and as such may require a larger discussion regarding their overall health.
References
1. Overactive bladder (OAB): symptoms, diagnosis & treatment. Urology Care Foundation. Accessed August 7, 2023.
2. Overactive bladder – symptoms and causes. Mayo Clinic. Updated May 3, 2022. Accessed August 7, 2023.
3. Chae J, Yoo EH, Jeong Y, Pyeon S, Kim D. Risk factors and factors affecting the severity of overactive bladder symptoms in Korean women who use public health centers. Obstet Gynecol Sci. 2018 May;61(3):404-412. doi: 10.5468/ogs.2018.61.3.404. Epub 2018 May 8. PMID: 29780784; PMCID: PMC5956125.
4. Kawahara T, Ito H, Yao M, Uemura H. Impact of smoking habit on overactive bladder symptoms and incontinence in women. Int J Urol. 2020 Dec;27(12):1078-1086. doi: 10.1111/iju.14357. Epub 2020 Sep 1. PMID: 32875688; PMCID: PMC7754378.
5. Xing D, Wang YH, Wen YB, et al. Prevalence and risk factors of overactive bladder in Chinese children: A population‐based study. Neurourol Urodyn. 2019;39(2):688-694. doi:10.1002/nau.24251.
