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It's just the worry about not being able to control it! A qualitative study of living with overactive bladder


Correspondence should be addressed to Paula Nicolson, Professor of Social and Health Psychology, Department of Health and Social Care, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK (e-mail:


Objectives. This study reports the perceptions of patients with a diagnosis of OAB and people with undiagnosed OAB symptoms about their health-related quality of life (HRQL) and psychological consequences.

Design. A qualitative study which employed a series of in-depth, semi-structured individual and group interviews using thematic and interpretive techniques of data analysis.

Methods. A mixture of previously diagnosed patients and people bothered by OAB symptoms were recruited from three British cities. The interviews explored issues around HRQL. Data were transcribed verbatim and analysed thematically to draw out the context in which people experience OAB. The study design was reviewed by a Multi-Centre Research Ethics Committee and subjected to local research governance.

Results. OAB has devastating consequences for sufferers of both sexes which impact upon their HRQL, self-esteem and relationships. OAB without incontinence causes anxiety, fear of incontinence, a sense of depression and hopelessness all of which are worse for those with incontinence. Many sufferers feel too embarrassed to seek medical care.

Conclusions. The psychological and HRQL consequences for OAB sufferers overlap with trajectories associated with chronic illness. However, because many sufferers avoid admitting to the condition and/or seeking treatment the psychological costs to them are even greater than with a diagnosed illness because the disruption remains unacknowledged and therefore unresolved.