EURURO Vol. 72 No. 3

402 476

Platinum Priority – Voiding Dysfunction
Editorial by Mikkel Fode and Jens Sønksen on pp. 408–409 of this issue
Qualitative Exploration of the Patient Experience of
Underactive Bladder
Alan D. Uren Nikki Cotterill Christopher Harding Christopher Hillary
Christopher Chapple Monique Klaver Dominique Bongaerts Zalmai Hakimi
Paul Abrams
a Department of Urology, Bristol Urological Institute, Bristol, UK; bDepartment of Urology, Freeman Hospital, Newcastle, UK; c Department of Urology, Royal
Hallamshire Hospital, Sheffield, UK; dAstellas Pharma B.V., Leiden, The Netherlands
available at
journal homepage:
Article info
Article history:
Accepted March 29, 2017
Associate Editor:
Christian Gratzke
Keywords:
Detrusor underactivity
Patient reported outcomes
Qualitative
Quality of life
Underactive bladder
Please visit
to read and
answer questions on-line.
The EU-ACME credits will
then be attributed
automatically.
Abstract
Background: Underactive bladder (UAB) is considered the symptom complex associated
with the urodynamic diagnosis of detrusor underactivity.
Objective: 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.
Design, setting, and participants: 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.
Results: 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 >30 ml ( n = 34, 77%, median: 199 ml) 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.
Conclusions: 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.
Patient summary: The symptoms, signs, and impact on quality of life of underactive
bladder are described by patients with the condition.
# 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.
* Corresponding author. Bristol Urological Institute, Learning and Research Building, Southmead
Hospital, Bristol BS10 5NB, UK. Tel. +44-1174147934.
E-mail address: (A.D. Uren).
0302-2838/# 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.