Associations of Situational Urgency Cue Responses in Women with High Bother Overactive Bladder

Objectives: Validated patient surveys for urinary symptoms, particularly overactive bladder (OAB), focus mainly on bother of core symptoms (urgency, frequency and nocturia). Many patients with overactive bladder report situational cues (running water, stress, cold, etc.) or triggers which acutely increase symptoms and have large impact on quality of life. This study was designed to investigate the relationship between situational cues and OAB symptom bother to further describe OAB phenotypes.

Methods: Patients scheduled for clinically-indicated urodynamic studies (UDS) completed surveys to characterize OAB (ICIQ-OAB and OAB-V3) and responses to situational cues (validated long-form cues survey and a novel short-form cues survey). Participants were divided into two groups based on ICIQ 5b response to urinary urgency bother question (low bother urgency (0-5) vs. high bother urgency (6-10)). Participants who responded equivocally, score of “2” on 0-5 Likert scale, to ICIQ 5a urgency symptom question were excluded from analysis for neutral answer. Sociodemographic, medical history, and urodynamics study results were collected for comparison.

Results: A total of 47 female participants were enrolled and 36 meet inclusion criteria for defined groups of low bother (n=15) and high bother (n=21). The mean age was 60.0±10.0 years and majority were white (86%) which did not significantly differ between groups. The high bother group had more detrusor overactivity on UDS but this did not reach significance, n=3 (15) vs 1 (7), p= 0.4. The high bother group scored significantly higher all cue items in the long-form (table 1) while only “running water” in the short form cues survey differed between groups (table 2). “Phone calls” were consistently non-triggering cues and the “running water” cue was bothersome in both long and short cue surveys.

Conclusions: Individuals with high bother urinary urgency are more likely to report positive cue responses which can lead to increased urinary urgency. Although multiple environmental, mood, and cognitive cues were associated with high-bother urinary urgency, only exposure to “running water” was significantly associated with high-bother urgency in both the long and short form surveys. A cue-responsive OAB phenotype may exist of which is identified by survey questions or even exposure.