The most bothersome lower urinary tract symptoms as reported by men and by women, "Beyond the Abstract," by Arnav Agarwal, Leyla Eryuzlu, Rufus Cartwright, and Kari A.O. Tikkinen

BERKELEY, CA (UroToday.com) - The bother experienced by individuals with lower urinary tract symptoms (LUTS) has significant impact on health-related quality of life and is also linked to considerable personal and societal expenditures. LUTS can be divided into three categories: storage symptoms (increased urinary frequency, nocturia, urinary urgency, and urinary incontinence); voiding symptoms (slow stream, splitting or spraying, intermittent stream, hesitancy, straining, and terminal dribble); and post-micturition symptoms (feeling of incomplete emptying and post-micturition dribble).

Symptom bother is of clinical importance given its impact on both quality-of-life, and treatment seeking. While many investigators claim a specific LUTS to be the “most bothersome” or “one of the most bothersome,” few have, in fact, measured the relative degree of bother across all LUTS. Furthermore, no study has previously sought to identify the most bothersome LUTS in a population-based study of both genders across a wide age range.

In the Finnish National Nocturia and Overactive Bladder (FINNO) Study, questionnaires were mailed to 3,000 men and 3,000 women randomly identified from the Population Register Centre of Finland. Frequency and degree of bother of twelve LUTS (hesitancy, weak stream, incomplete emptying, straining, daytime frequency, nocturia, urgency, urgency urinary incontinence, pain/burning, post-micturition dribble, stress urinary incontinence, and other incontinence) were measured using the Danish Prostatic Symptom Score questionnaire.

The study was comprised of 3,727 individuals (62.4% response). At the individual level, both males and females who experienced UUI were more likely to rate it as causing at least moderate bother, compared to sufferers of other LUTS. At the population level, however, urgency was the most frequently reported symptom to cause at least moderate bother. Women experienced greater population burden of both stress incontinence and urgency incontinence than men. In contrast, there was a higher population-level prevalence of bothersome voiding symptoms and post-micturition dribble among men.

Interestingly, some symptoms which are commonly overlooked may actually deserve more consideration. While post-micturition dribble is often ignored in men, it was found to be the most common cause of bother at the population level among men. Such symptoms should receive similar research attention as more widely recognised problems such as urinary urgency and nocturia.

Written by:
Arnav Agarwal,a, b Leyla Eryuzlu,a, b Rufus Cartwright,c, d and Kari A.O. Tikkinena, e as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

aDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
bFaculty of Health Sciences, McMaster University, Hamilton, ON, Canada
cDepartment of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
dDepartment of Urogynaecology, St Mary’s Hospital, London, United Kingdom
eDepartment of Urology and Department of Public Health, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland

What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women - Abstract

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