title: Qualitative Exploration of the Patient Experience of Underactive Bladder.
abstract: Underactive bladder (UAB) is considered the symptom complex associated with the urodynamic diagnosis of detrusor underactivity.
  
  
  
  The aim of this research was to investigate the patient reported experience of the symptoms, signs, and impact of UAB. This research is also part of the initial qualitative phase for the development of a new patient reported outcome measure for the assessment of UAB.
  
  
  
  Qualitative methods were used to understand the experience of UAB from a patient perspective, in a purposive sample of male (n=29) and female (n=15) patients aged 27-88 yr (mean: 64 yr), diagnosed with a primary diagnosis of detrusor underactivity, with or without coexisting urological conditions. Semistructured interviews were conducted in Bristol, UK.
  
  
  
  Male and female patients reported a variety of lower urinary tract symptoms and associated impact on quality of life. Storage symptoms of nocturia, increased daytime frequency, and urgency, and the voiding symptoms of slow stream, hesitancy, and straining were reported by over half of the patients. A sensation of incomplete emptying and postmicturition dribble were also frequently described. Most had a post void residual >30ml (n=34, 77%, median: 199ml) with many reporting urinary tract infections, a history of self-catheterisation, and some experiencing occasional acute retention episodes. These symptoms and signs can have a broad impact on quality of life including having to plan their daily activities around the location of toilets, disruption to sleep, social life, and associated effect on family and friends.
  
  
  
  Knowledge of the lived experience of UAB obtained in the current study will be used for the development of a new patient reported outcome measure and help inform the current working definition of UAB.
  
  
  
  The symptoms, signs, and impact on quality of life of underactive bladder are described by patients with the condition.
authors.affiliation: Department of Urology, Bristol Urological Institute, Bristol, UK. Electronic address: Alan.uren@bui.ac.uk.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Uren
authors.affiliation: Department of Urology, Bristol Urological Institute, Bristol, UK.
authors.forename: Nikki
authors.initials: N
authors.lastname: Cotterill
authors.affiliation: Department of Urology, Freeman Hospital, Newcastle, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Harding
authors.affiliation: Department of Urology, Royal Hallamshire Hospital, Sheffield, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hillary
authors.affiliation: Department of Urology, Royal Hallamshire Hospital, Sheffield, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Chapple
authors.affiliation: Astellas Pharma B.V., Leiden, The Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: Klaver
authors.affiliation: Astellas Pharma B.V., Leiden, The Netherlands.
authors.forename: Dominique
authors.initials: D
authors.lastname: Bongaerts
authors.affiliation: Astellas Pharma B.V., Leiden, The Netherlands.
authors.forename: Zalmai
authors.initials: Z
authors.lastname: Hakimi
authors.affiliation: Department of Urology, Bristol Urological Institute, Bristol, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Abrams
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D004739:England; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D000071066:Patient Reported Outcome Measures; D036301:Qualitative Research; D011788:Quality of Life; D012919:Social Behavior; D001743:Urinary Bladder / Q000503:physiopathology*; D001745:Urinary Bladder Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D014549:Urinary Incontinence / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D016055:Urinary Retention / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D014563:Urodynamics
keywords: Detrusor underactivity; Patient reported outcomes; Qualitative; Quality of life; Underactive bladder