title: Defining and managing overactive bladder: disagreement among the experts.
abstract: OBJECTIVE
  To better understand experts' perceptions of the definition of overactive bladder (OAB) and the evaluation and treatment of OAB in women.
  
  
  METHODS
  OAB has been defined by the International Continence Society as "urinary urgency, with or without urge urinary incontinence, usually with frequency and nocturia." Under the current definition, people with very different clinical conditions are included under the OAB umbrella. In the present study, 12 interviews with leading urologic, gynecologic, and geriatric practitioners in urinary incontinence and OAB were performed. Questions were asked about their perception and agreement with the current definition of OAB. The interviews were audiotaped and transcribed verbatim. The grounded theory method was used to analyze the data.
  
  
  RESULTS
  Overall, a great amount of variability was found in the definition and management of OAB. Four categories of definitions were derived from the qualitative analysis: the current OAB definition is adequate, OAB is a constellation of symptoms, OAB should include the fear of leakage, and OAB is a marketing term. Although some consensus has been reached on the evaluation, several areas have demonstrated disagreement over elements of the evaluation. Experts also believed that OAB is a chronic condition, with symptom variability, and has no cure. Managing patient expectations is essential, because OAB is challenging to treat. A focus was placed on behavioral therapy.
  
  
  CONCLUSIONS
  The experts disagreed over the definition and workup of OAB. However, the experts agreed that OAB is a chronic condition with a low likelihood of cure.
authors: Section of Urology and Renal Transplantation, Virginia Mason Medical Center, Seattle, WA, USA.
authors: Una J
authors: UJ
authors: Lee
authors: Victoria C S
authors: VC
authors: Scott
authors: Rezoana
authors: R
authors: Rashid
authors: Ajay
authors: A
authors: Behniwal
authors: Alan J
authors: AJ
authors: Wein
authors: Sally L
authors: SL
authors: Maliski
authors: Jennifer T
authors: JT
authors: Anger
mesh_terms: D001291:Attitude of Health Personnel; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D036301:Qualitative Research; D009626:Terminology as Topic; D053201:Urinary Bladder, Overactive / Q000175:diagnosis* / Q000628:therapy*; D014572:Urology
references: Urology. 2002 Nov;60(5 Suppl 1):7-12; discussion 12
references: 12493342
references: Eur Urol. 2005 Mar;47(3):273-6
references: 15716186
references: Female Pelvic Med Reconstr Surg. 2011 Jan;17(1):4-7
references: 22453666
references: Soc Sci Med. 1990;30(11):1161-72
references: 2360052
references: Urology. 1997 Dec;50(6A Suppl):1-114
references: 9446279
references: Can Urol Assoc J. 2011 Oct;5(5 Suppl 2):S135-6
references: 21989525
references: Neurourol Urodyn. 2007;26(6):757-8; discussion 759-60
references: 17480032
references: Eur Urol. 2011 Apr;59(4):629-36
references: 21306820
references: Urology. 2003 Nov;62(5 Suppl 2):28-37; discussion 40-2
references: 14662404
references: BJU Int. 2001 Jun;87(9):760-6
references: 11412210
references: Neurourol Urodyn. 2011 Sep;30(7):1295-9
references: 21538495
references: Urology. 2010 Mar;75(3):526-32, 532.e1-18
references: 20035977
references: BJU Int. 2011 Oct;108(7):1132-8
references: 21231991
references: Neurourol Urodyn. 2002;21(2):167-78
references: 11857671