Symptom and Environmental Cues Related to Urinary Urgency and Urinary Urgency Incontinence

Urinary urgency and leakage when arriving home are common in overactive bladder syndrome (OAB). This phenomenon, often termed latchkey incontinence, may be an example of a Pavlovian response to a conditioned stimulus. If so, other cues closely associated with urination may serve as conditioned stimuli as well. In this study we investigated the extent to which environmental and symptom cues are associated with urinary urgency (UU) and urinary urgency incontinence (UUI).

 A previously developed questionnaire¹ containing 21 environmental, 5 symptom, and 3 unlikely cues was administered to 306 subjects randomly drawn from a panel of respondents maintained by Zoomerang, Inc. Approximately half the sample had self-reported diagnoses of OAB and half did not. The sample was 66% female, with average age of 53.9 years. Each cue was rated on a 5-point scale. Mean scores for individual cues in the diagnosed (DX) and undiagnosed (UNDX) groups were compared as were the mean scores for likely and unlikely cues.

The most frequently reported symptom cues for both UUI and UU related to having full bladder either upon awakening or otherwise. The most frequently rated environmental cues for both UUI and UU were “When on the way to the bathroom” and “Arrival at/ opening front door.” The DX group reported significantly more cues associated with both UUI and UU than the UNDX group. Within subjects, responding to three cues unlikely to be associated with urination was significantly lower than responding to the 26 likely cues, indicating that respondents were not simply responding to all items in a similar way.

These results are consistent with the ideas that UUI and UU may be partially under the control of Pavlovian conditioning and that research on extinction of conditioned cues as a treatment for OAB is warranted.