Zoe Kopp

The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well‐being in men and women: results from the EPIC study

To examine the effect overactive bladder (OAB) and other lower urinary tract symptoms (LUTS) on health‐related quality of life (HRQoL) in a population sample, as OAB often occurs in conjunction with many other LUTS.

Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction

Study Type – Symptom prevalence (prospective cohort)

The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study

To estimate and compare the prevalence and associated bother of lower urinary tract symptoms (LUTS) in the general populations of the USA, UK and Sweden using current International Continence Society (ICS) definitions, as no previous population‐based studies evaluating the prevalence of LUTS in the USA, using the 2002 ICS definitions, have been conducted.

Impact of overactive bladder symptoms on employment, social interactions and emotional well-being in six European countries

To determine the impact of overactive bladder (OAB) symptoms on issues related to employment, social interactions, and emotional well‐being in a population aged 40–64 years.

The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS

To evaluate the impact of lower urinary tract symptoms (LUTS) on urinary‐specific health‐related quality of life (HRQL), generic health indices, depression and anxiety in a population‐representative sample of men and women, as research has linked LUTS with reduced HRQL and depression, but little is known about the effects of individual LUTS on HRQL, depression and anxiety.

Urinary Incontinence and its Relationship to Mental Health and Health-Related Quality of Life in Men and Women in Sweden, the United Kingdom, and the United States

BACKGROUND Differences in health burden associated with urinary incontinence (UI) subtypes have been previously described, but the majority of studies are in women. Additional research is needed to examine the prevalence and burden of UI subtype including postmicturition incontinence, nocturnal enuresis, coital incontinence, and incontinence for unspecified reasons. OBJECTIVE Examine the burden of UI in men and women in Sweden, the United Kingdom, and the United States. DESIGN, SETTING, AND PARTICIPANTS Secondary analyses of the Epidemiology of Lower Urinary Tract Symptoms (EpiLUTS), a cross-sectional Internet survey, were performed. Participants who reported UI were categorized as (1) urgency urinary incontinence (UUI) only, (2) stress urinary incontinence (SUI) only, (3) mixed urinary incontinence (MUI), (4) UUI plus other incontinence (OI), (5) SUI plus OI, or (6) OI. Differences in health outcomes across UI groups were explored by gender using descriptive statistics and general linear models. MEASUREMENTS Outcomes included treatment seeking for urinary symptoms, perception of bladder condition, depression, anxiety, and health-related quality of life (HRQL). RESULTS AND LIMITATIONS Of 14 140 men and 15 860 women, 6479 men (45.8%) and 10 717 women (67.6%) reported UI. The most prevalent UI subgroups were OI in men and SUI in women. MUI and SUI plus OI had the greatest treatment seeking among men, whereas MUI and UUI plus OI had the greatest treatment seeking among women. Men with MUI had the highest rates of anxiety, followed by those with UUI plus OI and SUI plus OI, and OI with a similar trend observed for depression. Anxiety and depression were highest in SUI plus OI and MUI women. MUI and UUI plus OI men and women had significantly lower HRQL compared with other UI groups. CONCLUSIONS UI is common in men and women aged >40. Individuals with UUI combined with SUI or OI bear a greater mental health burden and report poorer HRQL.

The impact of overactive bladder on mental health, work productivity and health-related quality of life in the UK and Sweden: results from EpiLUTS

Study Type – Symptom prevalence (prospective cohort)

The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS.

To assess the (i) the overlap between voiding, storage, and postmicturition symptoms; and (ii) the relative effect of bother and implications for treatment seeking within these symptom groups, using data from the EpiLUTS study.

Prevalence, Severity, and Symptom Bother of Lower Urinary Tract Symptoms among Men in the EPIC Study: Impact of Overactive Bladder

BACKGROUND Lower urinary tract symptoms (LUTS) are prevalent among men. OBJECTIVE To describe the prevalence, severity, and symptom bother of LUTS in all men and men with overactive bladder (OAB) symptoms in the EPIC study. DESIGN, SETTING, AND PARTICIPANTS A secondary analysis of data from EPIC, a multinational population-based survey of 19,165 adults, was performed. Current International Continence Society definitions were used for individual LUTS and OAB; OAB cases were defined as men reporting urgency. MEASUREMENTS Participants were asked about the presence of individual LUTS and associated symptom bother. LUTS severity was measured using the International Prostate Symptom Score (IPSS). RESULTS AND LIMITATIONS There was substantial overlap of storage, voiding, and postmicturition symptoms among all men (n=7210) and in men with OAB symptoms (n=502); men with OAB symptoms were more likely to experience multiple LUTS subtypes. Among both populations, nocturia was the most commonly reported symptom, except for urgency (the hallmark symptom) among men with OAB symptoms; terminal dribble and sensation of incomplete emptying were the most common voiding and postmicturition symptoms. The prevalence of all LUTS increased with age among the general population; only storage LUTS increased with age among men with OAB symptoms. Number of LUTS and mean IPSS increased with age in both populations but were higher among men with OAB symptoms at all ages; the proportion reporting moderate-severe LUTS was higher than the general population (30% vs 6%). The proportion of men with OAB symptoms reporting symptom bother increased with urgency severity and severity and number of LUTS. LUTS severity may have been underestimated by the IPSS, which does not assess incontinence. CONCLUSIONS Men with LUTS commonly experience coexisting storage, voiding, and postmicturition symptoms, emphasizing the need for comprehensive urologic assessments. Men with OAB symptoms reported more LUTS and greater severity than the general population. Symptom bother was related to number of LUTS and urgency severity.

Symptom Bother and Health Care–Seeking Behavior among Individuals with Overactive Bladder

OBJECTIVE To estimate symptom bother and health care seeking among individuals with overactive bladder (OAB; ie, cases) using current International Continence Society definitions. METHODS This was a nested case-controlled analysis of data from the EPIC study, a population-based, cross-sectional survey of adults in five countries. Cases and matched controls were asked about risk factors, use of coping techniques, and health care seeking for urinary symptoms. Cases were asked about symptom bother and assessed with the Overactive Bladder-Validated 8 and Patient Perception of Bladder Condition instruments. RESULTS Among cases (n=1434), 54% reported symptom bother; rates were similar between men (54%) and women (53%). Significantly more men with urinary incontinence (UI) reported bother (77%) than women with UI (67%; p<or=0.05). Among cases with UI who reported bother, more women (73%) than men (51%) used a urinary symptom coping technique, and the proportions were significantly greater than controls (men: 10%; women: 15%; p<or=0.05 for cases with UI vs. controls). Among cases using coping techniques, 63% of men and 69% of women initiated a conversation with a health care provider. Initiation of conversation with a health care provider was highest among cases who had a doctor visit within 6 mo (odds ratio [OR], 2.8), used coping techniques (OR, 2.2), or reported symptom bother (OR, 2.2). CONCLUSIONS Cases reporting symptom bother, particularly those with UI, were significantly more likely to use coping techniques and seek health care advice. Clinicians should screen for OAB in all cases and assess symptom bother in those affected to guide diagnosis and treatment.