Prevalence and Characteristics of Urinary Incontinence in a Treatment-Seeking Male Prospective Cohort - Results from the LURN Study

Male urinary incontinence (UI) is thought to be infrequent. We sought to describe the prevalence of UI in a male treatment-seeking cohort enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN).

The inclusion/exclusion criteria, including men with prostate cancer or a neurogenic bladder, have been previously reported. LURN participants prospectively completed questionnaires regarding lower urinary tract symptoms (LUTS) and other clinical variables. Men were grouped based on type of incontinence (1=non-UI; 2=post-void dribbling [PVD] only; 3=UI). Comparisons were made using analysis of variance and multivariable regression.

Among 477 men, 24% reported non-UI, 44% PVD only, and 32% UI. Black men and those with sleep apnea were more likely to be in the UI group compared with the non-UI group (odds ratio [OR]=3.2, p=0.02 and OR=2.73, p=0.003, respectively). UI was associated with significantly (p<0.001) higher bother compared to those without leakage. Compared to men without UI and men with PVD only, men with UI were significantly (p<0.01) more likely to report higher scores (more severe symptoms) on patient-reported outcomes measurement information system (PROMIS) questionnaires regarding bowel issues, depression, and anxiety, compared to those without UI.

UI is common among treatment-seeking men. This is concerning because the guideline-recommended questionnaires for assessing male LUTS do not query for UI. Thus, clinicians may be missing an opportunity to intervene and improve patient care. This provides a substantial rationale for a new or updated symptom questionnaire that provides a more comprehensive symptom assessment.

The Journal of urology. 2018 Feb 22 [Epub ahead of print]

Brian T Helfand, Abigail R Smith, H Henry Lai, Claire C Yang, John L Gore, Brad A Erickson, Karl J Kreder, Anne P Cameron, Kevin P Weinfurt, James W Griffith, Aaron Lentz, Pooja Talaty, Victor P Andreev, Ziya Kirkali, Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)

NorthShore University Health System, Evanston, IL. Electronic address: ., Arbor Research Collaborative for Health, Ann Arbor, MI., Washington University School of Medicine, St. Louis, MO., University of Washington, Seattle, WA., Department of Urology, University of Iowa, Iowa City, IA., University of Michigan, Ann Arbor, MI., Duke University Medical Center, Durham, NC., Feinberg School of Medicine, Northwestern University, Chicago, IL., NorthShore University Health System, Evanston, IL., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.