OBJECTIVES: Many patients with OAB attempt self-management and are reluctant to initiate an OAB discussion with a physician. We sought to identify patient characteristics associated with patient initiation of an OAB discussion with a physician. METHODS: Of 24,866 respondents of the 2009 National Health & Wellness Survey, an internet-based questionnaire on healthcare attitudes, behaviors, and outcomes, 2750 recontacted respondents qualified for and completed a longitudinal survey. Eligible subjects (≥18 y) had an OAB Awareness Total score of >14 (men) or >16 (women) or used an OAB prescription medication. Exclusion criteria included current pregnancy or catheter use, hematuria, urinary tract infection symptoms, benign prostatic hyperplasia (BPH), use of BPH medication, or prostate cancer. Analysis of proportions and logistic regression analysis (2-tailed P<0.05 significance level) identified patient characteristics associated with initiation of OAB discussions with a physician.  RESULTS: 1325 of 2750 (48%) OAB patients reported initiating an OAB discussion with a physician. These respondents (mean age 52 y) were predominantly female (65%) and white (71%). Significant variables associated with initiation of an OAB discussion were divorced/separated/widowed vs single, more familiar with OAB, a longer duration of bladder control symptoms, lower SF-12 Physical Component Summary score , better daily activity function, greater pill burden, and regular physician contact (Table). Patient age, income, employment status, and health insurance coverage were not significantly associated with a patient-physician OAB discussion. CONCLUSIONS: Patients are more likely to initiate an OAB discussion with their physician if they have regular contact with the physician, a longer duration of symptoms, are familiar with OAB, and have worse physical quality of life. Socioeconomic variables or drug insurance coverage were not significantly associated. These findings suggest that the physician relationship is important for help seeking behavior; and there is a need for early patient education on OAB symptoms and treatments.