(Published March 2011)

Counseling Tips

Screening for OAB

• Use these questions to screen patients for OAB:
• Do you ever feel a compelling urge to urinate that is difficult to defer?
• Do you ever leak urine? Under what circumstances?
• How often do you urinate in 24 hours?
• How many times do you get up to urinate at night?

Assessing the effects of OAB

• Use these questions to assess the effects of OAB on the patient's quality of life:
• Do symptoms such as an urgent need to urinate, frequent urination, or leaking of urine affect your ability to:
  • Socialize?
  • Travel?
  • Fulfill your occupational or personal roles?
  • Be sexually active?
• Do your symptoms limit your ability to participate in or attend activities and events outside the home?
• Do you ever experience embarrassment because of your symptoms?
• Has anyone expressed concern about your symptoms?

Educating patients

• Educate patients about:
• Bladder function
• Fluid and dietary management
• Timed or prophylactic voiding
• Bladder training regimens
• Keeping a bladder diary
• Pelvic floor exercises
• Refer patients to educational materials (see Resources for Patients section).

Supporting lifestyle changes

• Advise patients to:
• Avoid dietary bladder irritants (e.g., alcohol, caffeine, tomatoes, citrus).
• Moderate fluid intake.
• Improve their mobility.
• Address coexisting health issues.
• Improve bowel habits and regularity (e.g., increase fiber intake).
• Enlist caregiver's support, as appropriate.

Exploring treatment options

• Explore available options with patients.
• Explain the options for non-pharmacologic and pharmacologic therapy.
• Discuss potential drug-related side effects and methods for minimizing or avoiding them.
• Discuss the timing of referral to a urologist or gynecologic specialist for treatment.
• Encourage patients to ask questions and seek additional sources of information and support.

Referring for specialist's care

• Refer to a specialist patients with:
• Hematuria
• Unclear diagnosis
• Presence of voiding symptoms
• Presence of pelvic organ prolapse
• No response to therapy
• Elevated post-void residual
• Previous pelvic surgery
• Bladder pain