Alan J. Wein, MD Professor and Chair. Division of Urology University of Pennsylvania School of Medicine Chief of Urology Hospital of the University of Pennsylvania Philadelphia, Pennsylvania

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		Is the symptom complex of overactive bladder frequently being missed as a diagnosis by the family doctor?

Jump to bottom of the page Well, I think that the family doctor (primary care physician, whatever) needs to ask the patient whether they have a concern over the number of times they urinate during the day, number of times they get up at night, whether they can control the urge to urinate. That is, if they feel the urge to go, whether they can postpone it sufficiently and get to the bathroom comfortably on time or whether they have to play like the Michigan football team and run over everybody on the way to the toilet. I think that's basically how you recognize it. Now, I guess you could say that while somebody voids every hour but they're used to voiding every hour during the day and it doesn't bother them, do they really have to be treated? And I guess the answer is no, as long as they understand that that's not really normal. So I think that perhaps it is overlooked because people tend to regard what they do as normal as long as it doesn't hurt them or as long as someone doesn't say to them, "Gee, you know that's abnormal." But if they understand that it's not normal to go to the bathroom 12 times a day, then I think perhaps more people would complain to the family doctor about their urinary frequency. So in that sense I think it is overlooked. I think the people who are bothered by the urinary symptoms will tell their primary care physician about them as long as they're asked. If they're not asked about it, if they've just said, "How's your heart? Do you have any chest pain? Do you have this, do you have that?" then I think that many of them won't ask because they assume rightfully or wrongfully that the person, the primary care physician, is not very interested; that they're probably not very good at treating it, besides there's probably no treatment for it anyway. And if they're older they assume that it's an inevitable consequence of aging. So for all those reasons they perhaps won't mention it unless they're asked.

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