Goals
There is little information about how often or in what contexts people with overactive bladder (OAB) use compensatory behaviors ("coping") to manage symptoms. We sought to examine how frequently women with OAB use coping behaviors and whether these are associated with psychosocial factors.
Methods
One hundred and twenty adult women with OAB completed the OAB questionnaire (OAB-q), the ICIQ-FLUTS questionnaire, PROMIS Anxiety and Depression, Perceived Stress Scale, patient perception of bladder status, and demographic and clinical data.
Responses to five items from the OAB-q quality of life scale that asked about coping with OAB symptoms (i.e., “compensatory coping behaviors”) were summed to generate a total coping score.
Linear regression was used to identify associations between individual coping behaviors, total coping scores, and exposure variables.
Results
The majority (88%) of subjects reported using at least one compensatory coping behavior at least “some of the time,” with “locating the nearest bathroom in a new location” being the most frequent.
Higher BMI, lower education, use of medication for OAB and urge incontinence, as well as severity of urinary symptoms were associated with higher coping scores.
Beyond the influence of OAB severity, greater anxiety (β = 0.15, 95% CI [0.05-0.26], p = 0.004) and stress (β = 0.16 [ 0.03-0.25], p = 0.02) were significantly associated with higher total coping scores, although depression was not.
Conclusions Compensatory bladder behaviors (coping) were common in women with OAB and were associated with greater severity of urinary symptoms and greater anxiety and stress. More studies are needed to understand how coping behaviors and psychosocial factors are related, as they may represent important opportunities for interventions. |
Women carry a significant burden affecting voiding behavior, from genetic/familial effect on pelvic support mechanism, anatomy, childbearing and hormonal influence to cultural effects of clothing/urinating posture.
Add in bladder dysfunction or weak urination, and the problem and fear of discovery are reflected in coping behavior, from knowing where each bathroom is to restricting or avoiding the activity altogether. The circle is completed with anxiety causing even more defensive frequency, perceived difficulty urinating because there is hardly any urine in the bladder, and pelvic pain due to excessive guarding.
