Aims
of Study:
The aim of this study was to collect data on symptoms of bladder dysfunction
in a large German population sample of patients
visiting primary care doctors, urologists or gynecologists
for any medical reason. Awareness of the problem
in the medical community was investigated by matching
patients´ symptoms to doctors´ diagnoses and looking
at treatment habits.
Methods:
During a total study period of approximately 4 months a total of 2662
practices of primary care physicians, urologists
and gynecologists asked their visiting patients
to fill out a simple questionnaire consisting
of 4 questions related to symptoms of bladder
dysfunction. The physicians were asked to discuss
the answers with their patients during the same
visit and to make a diagnosis. Based upon the
diagnosis they were asked whether pharmacotherapy
would be initiated or the patient would be referred
to a specialist.
Results:
TABLE
1: Demographics
|
|
TOTAL
N (%)
|
UROLOGISTS
N (%)
|
GYNECOLOGISTS
N (%)
|
PRIMARY
CARE
N (%)
|
|
PATIENTS
|
211,648 (100)
|
14,711
(7)
|
41,150
(19.4)
|
155,787
(73.6)
|
|
CENTERS
|
2,662
(100)
|
165
(6.1)
|
446
(16.8)
|
2,051
(77.1)
|
|
FEMALES
|
137,222* (67.4)
|
5,883*
(4.3)
|
41,150*
(30)
|
90,189*
(65.7)
|
|
MALES
|
66,433*
(32.6)
|
7,994*
(12)
|
-------
|
58,439*
(88)
|
|
AGE
: 40 – 80 years
|
74,558* (84.8)
|
13,186*
(92.7)
|
20,902*
(52.1)
|
140,470*
(92.7)
|
*
Differences due to missing values
Data
of 198,230 patients were available for analysis.
Overall 22.4% reported symptoms attributable to
mixed and 8% to stress incontinence; 43.7% had
no symptoms of bladder dysfunction. The prevalence
of symptoms attributable to overactive bladder
was 25.9%, with the most commonly reported symptom
being frequency (41.9%), followed by urgency (24.3%)
and urge incontinence (20.2%). Doctors awareness
of symptoms was rather poor (see Table 2)
TABLE 2: Summary of Results
|
Number
of patients seen by
|
Symptoms
of
Overactive
Bladder
|
Symptoms of
Mixed
incontinence
|
Symptoms of
Stress
Incontinence
|
No
Symptoms
|
|
|
Reported
by patient
N
(100%)
|
Diagnosed
by doctor
N
(%)
|
Reported
by patient N (100%)
|
Diagnosed
by doctor
N
(%)
|
Reported
by patient
N
(100%)
|
Diagnosed
by doctor
N
(%)
|
Reported
by patient
N
(100%)
|
Diagnosed
by doctor
N
(%)
|
|
All
doctors
|
51,407
|
21,871
(42.5%)
|
44,420
|
23,303
(52.5%)
|
15,762
|
9,764
(62.0%)
|
86,641
|
85594
(98.8%)
|
|
Urologists
|
5,945
|
2,565
(43.1%)
|
2,893
|
1,434
(49.5%)
|
719
|
561
(88.0%)
|
4,693
|
4,585
(97.7%)
|
|
Gynecol.
|
6,888
|
2,892
(42.0%)
|
7,795
|
3883
(49.8%)
|
4,368
|
2845
(65.1%)
|
20,153
|
19,933
(98.9%)
|
|
Primary
care
|
38,574
|
16,414
(42.6%)
|
33,732
|
17,986
(53.3%)
|
10,675
|
6,358
(59.6%)
|
61,795
|
61,076
(98.8%)
|
Drugs
for the treatment of the symptoms of overactive
bladder were prescribed by about 80% of the urologists;
however, only 40 – 45% of the gynecologists and
the primary care doctors considered this option.
Conclusions:
Considering the high prevalence of lower urinary tract symptoms in a growing
elderly population and the impact on the individual
quality of life as well as the social system,
further educational efforts seem necessary to
increase awareness for this problem in the medical
community.
This study was sponsored by a grant from Pharmacia & Upjohn GmbH in
Erlangen, Germany.
