Defining Bladder Health in Women and Girls: Implications for Research, Clinical Practice, and Public Health Promotion

Bladder health in women and girls is poorly understood, in part, due to absence of a definition for clinical or research purposes. This article describes the process used by a National Institutes of Health funded transdisciplinary research team (The Prevention of Lower Urinary Tract Symptoms [PLUS] Consortium) to develop a definition of bladder health.

The PLUS Consortium identified currently accepted lower urinary tract symptoms (LUTS) and outlined elements of storage and emptying functions of the bladder. Consistent with the World Health Organization's definition of health, PLUS concluded that absence of LUTS was insufficient and emphasizes the bladder's ability to adapt to short-term physical, psychosocial, and environmental challenges for the final definition. Definitions for subjective experiences and objective measures of bladder dysfunction and health were drafted. An additional bioregulatory function to protect against infection, neoplasia, chemical, or biologic threats was proposed.

PLUS proposes that bladder health be defined as: "A complete state of physical, mental, and social well-being related to bladder function and not merely the absence of LUTS. Healthy bladder function permits daily activities, adapts to short-term physical or environmental stressors, and allows optimal well-being (e.g., travel, exercise, social, occupational, or other activities)." Definitions for each element of bladder function are reported with suggested subjective and objective measures.

PLUS used a comprehensive transdisciplinary process to develop a bladder health definition. This will inform instrument development for evaluation of bladder health promotion and prevention of LUTS in research, practice, and public health initiatives.

Journal of women's health (2002). 2018 May 24 [Epub ahead of print]

Emily S Lukacz, Tamara G Bavendam, Amanda Berry, Cynthia S Fok, Sheila Gahagan, Patricia S Goode, Cecilia T Hardacker, Jeni Hebert-Beirne, Cora E Lewis, Jessica Lewis, Lisa Kane Low, Jerry L Lowder, Mary H Palmer, Ariana L Smith, Sonya S Brady

1 Division of Female Pelvic Medicine and Reconstructive Surgery, University of California San Diego , San Diego, California., 2 National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health , Bethesda, Maryland., 3 Division of Urology, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania., 4 Department of Urology, University of Minnesota , Minneapolis, Minnesota., 5 Division of Academic General Pediatrics, University of California San Diego , San Diego, California., 6 Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham , Birmingham, Alabama., 8 Howard Brown Health, Rush University College of Nursing , Chicago, Illinois., 9 Division of Community Health Sciences, University of Illinois at Chicago , School of Public Health, Chicago, Illinois., 10 Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham , Birmingham, Alabama., 11 Yale School of Public Health , New Haven, Connecticut., 12 University of Michigan School of Nursing , Ann Arbor, Michigan., 13 Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University in St. Louis School of Medicine , St. Louis, Missouri., 14 School of Nursing, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina., 15 Division of Urology, University of Pennsylvania , Philadelphia, Pennsylvania., 16 Division of Epidemiology and Community Health, University of Minnesota School of Public Health , Minnesota, Minnesota.

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