Bladder problem may be linked to domestic violence: Hong Kong study

It calls for women suffering from syndrome to be screened at clinics for domestic aggression that may have occurred many years ago

PUBLISHED : Sunday, 14 August, 2016, 11:44pm
UPDATED : Monday, 15 August, 2016, 1:52am

Women displaying problems while urinating should be screened at clinics for domestic violence, researchers said.

This follows a medical study in which 7,6 per cent of women with overactive bladder syndrome were found to have been abused at home.

Although researchers believe the number was under-reported, they say the survey offers the government a new way to recognise the at-risk group.

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Most women said they were first subjected to verbal abuse, which was then followed by sexual and physical abuse.

Overactive bladder symptoms may have been brought on by anxiety resulting from abuse that could have taken place years ago, the researchers at Queen Mary Hospital said.

“We believed that taking every chance in identifying the at-risk group is worthwhile not only due to its possible devastating consequences, but also because victims of domestic violence may enter a vicious cycle if not dealt with properly,” the researchers said.

Liu Ngun-fung, former chairwoman of the Association for the Survivors of Women Abuse, a non-government organisation that helps abused women, welcomed the screening of patient groups but warned many would not seek medical treatment.

“Abused victims are usually silent and very hidden in the society,” Liu, who was a victim herself, said. “The organisation is often in a very passive position. We wait for victims to seek help on their own, or follow up on cases referred by social workers.”

The study by the Pok Fu Lam hospital’s obstetrics and gynaecology department is the first to look into the prevalence of domestic violence in Chinese patients with urinary symptoms attending the specialty.

It was published in scientific journal Public Library of Science last month.

Of 225 patients who attended the urogynaecology clinic with overactive bladder syndrome, 17 or 7.6 per cent with a median age of 56 reported having experienced domestic violence. Most of them, 15, were subject to verbal abuse, and three reported sexual abuse, and one physical abuse.

The prevalence rate was lower than previous studies that reported the overall incidence of domestic between 10.4 and 15.7 per cent, compared to 6.3 to 55 per cent in the United States.

Researchers said the under-reporting of cases was down to shame, stigma, tolerance and preservation of family harmony, which are commonly shared attitudes in Asia.

Victims of abuse showed a higher rate of lower abdominal pain, bowel irritation and urological symptoms, according to other overseas studies.

The Hong Kong study said those who suffered verbal abuse often saw an increase in cortisol hormone, a substance that may adversely affect health if conditions persist.

“A high anxiety level was found to be one of the contributing factors to the presentation of urinary symptoms,” the study said. “Verbal abuse may contribute to adverse psychological impacts on patients even though it did not cause any physical damage and resulted in high anxiety level in victims.”

Verbal abuse was found to be a more common form of abuse in Hong Kong, according to the study.

It said as Chinese culture is influenced by Confucianism and Buddhism, calling someone greedy, a liar or hateful may be considered abuse along with insults, threats and humiliation.

Researchers believe it is more effective to target women with overactive bladder symptoms who seek treatment directly from private specialists or public hospitals – rather than private clinics – along with divorcees and those with lower educational levels, both of which are also well established risk factors of abuse.