Prevalence of OAB in Asian Men: an epidemiological survey

British Journal of Urology: 93: 528-531, 2004

P Moorthy, et al

BJU Intl.pdf

Why this study?

• OAB is generally under treated and under diagnosed

• More reports on urge incontinence, not on OAB

• OAB reports on men is scarce, in particular in Asia

ObjectivesObjectives

• Determine the prevalence of OAB in Asian malesDetermine the prevalence of OAB in Asian males

• Determine the status of OAB as a problemDetermine the status of OAB as a problem

• Determine the demographic factors related to the occurrence of OABDetermine the demographic factors related to the occurrence of OAB

• Determine the degree of bother and treatment seeking rate in Asian Determine the degree of bother and treatment seeking rate in Asian menmen

MethodologyMethodology

• Questionnaire based surveyQuestionnaire based survey

– Created by an expert panelCreated by an expert panel– Translated into the local dialect, validatedTranslated into the local dialect, validated– Multiple-choice type of queriesMultiple-choice type of queries– Self-administered under supervision of a Self-administered under supervision of a

medically-trained personnelmedically-trained personnel

Survey PopulationSurvey Population

• TOTAL: Males : TOTAL: Males : 23692369

• Participating countries Participating countries

– PhilippinesPhilippines China– IndonesiaIndonesia MalaysiaMalaysia– SingaporeSingapore ThailandThailand

– Hong Kong Taiwan– Korea India– Pakistan

The OAB (ICS, 2001)

Urgency with or without urge incontinence usually

with frequency and nocturia

• Urgency = having strong desire to void urine

• Urge incontinence = involuntary loss of urine with urgency

• Frequency = voiding of > 8 times a day

• Nocturia = voiding of urine at night time

Definitions

Country specific prevalence of OAB

0

10

20

30

40

50

60

70

80

90

Chi

na

Hon

g K

ong

Indi

a In

done

sia

Kor

ea M

alay

sia

Pak

ista

n P

hili

ppin

es S

inga

pore

Tai

wan

Tha

iland

No

. of

res

po

nd

en

ts w

ith

OA

B

Prevalence of OAB among malesPrevalence of OAB among males

30

33

16

0

5

10

15

20

25

30

35

40

45

50

Asia (APCAB) Sweden Europe

***

**

* Moorthy et al . 2004 (general pop.)* Moorthy et al . 2004 (general pop.)** Geirsson et al. 1993 (general pop.)** Geirsson et al. 1993 (general pop.)*** Milsom et al., 2000 (general pop.)*** Milsom et al., 2000 (general pop.)

*

Distribution of different OAB symptoms in Asian males

0

10

20

30

40

50

A B C D E F G

Sy

mp

tom

s (

%)

A = FrequencyB = UrgencyC = Frequency and UrgencyD = Urge IncontinenceE = Urgency and Urge IncontinenceF = Frequency and Urge IncontinenceG = Frequency, Urgency and Urge Incontinence

Age-specific respondents with OAB

0

10

20

30

40

50

60

18-28 29-39 40-49 50-59 60-69 >70

Age-group

Res

po

nd

ents

wit

h O

AB

(%

)

OAB as a ProblemOAB as a Problem

• Degree of BotherDegree of Bother– Scoring from 0 to 5 Scoring from 0 to 5

0 – no bother, 5 – severe0 – no bother, 5 – severe

• Need for Leakage Protection in urge incontinenceNeed for Leakage Protection in urge incontinence

• Seeking HelpSeeking Help

Degree of bother in patients with OAB

0

10

20

30

40

50

60

70

80

Mild Moderate Severe

Degree of Bother

Res

pond

ents

OAB as a Problem: Rate of Seeking HelpOAB as a Problem: Rate of Seeking Help

No94%

6% Yes

• Age more than 70 years = 2.808

• Professional labor = 1.117

• Sitting type toilet = 1.070

• Urban dwelling = 1.306

Chances of OAB (odds ratio)

Demographic Factors Associated with a Higher Demographic Factors Associated with a Higher Prevalence of OABPrevalence of OAB

• Older age Older age

• Professionals Professionals

• Positive family history for voiding dysfunction (19% of respondents in this study)Positive family history for voiding dysfunction (19% of respondents in this study)

• Use of a sitting toiletUse of a sitting toilet

• Higher incomeHigher income

• Urban dwelling Urban dwelling

• Constitutional factors of OAB

Obesity, White race, Increasing age • Behavioural Risk factors

Consumption of caffeine, alcohol, tobacco, low daily physical activity

• Neurological Risk factors

Stroke, Paraplegia, Paralysis, Immobility and cognitive impairment