Perceptions of overactive bladder treatments among women, caregivers, and healthcare professionals: a systematic review and meta-synthesis

Abstract

Overactive bladder (OAB) is a common condition that substantially impairs quality of life yet remains underreported and undertreated. Understanding how women, caregivers, and healthcare professionals (HCPs) perceive OAB treatments may help improve patient-centered care. This systematic review and meta-synthesis aims to synthesize qualitative evidence on experiences and perceptions of OAB treatment. MEDLINE, Scopus, Google Scholar and CINAHL were searched from inception to January 2026 for qualitative studies exploring treatment experiences among women with OAB, their caregivers, and HCPs. Three reviewers independently screened studies, extracted data, and performed line-by-line coding. Data were synthesized using thematic synthesis. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) checklist. A GRADE-CERQual assessment was performed to evaluate confidence in the synthesized qualitative findings. Thirteen qualitative studies were included. Forty-five codes were identified and synthesized into five analytical themes: (1) the burden of treatment vs. the burden of illness, reflecting the tension between symptom burden and treatment-related challenges; (2) erosion of trust in the therapeutic alliance, driven by poor communication and unmet expectations; (3) the knowledge gap and desire for agency, highlighting unmet informational needs and preferences for shared decision-making; (4) psychosocial barriers to treatment engagement, encompassing stigma, embarrassment, isolation, and emotional distress; and (5) preference for low-burden treatments and resistance to behavioural change, reflecting preferences for convenient therapies and difficulties sustaining long-term behavioural interventions. Experiences of OAB treatment extend beyond symptom control and are shaped by psychosocial burden, healthcare interactions, treatment expectations, and the need for autonomy. Patient-centered communication, shared decision-making, and individualized support may improve treatment engagement, satisfaction, and adherence. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261289760 , Identifier: CRD420261289760.