Gender and age differences in the perception of bother and health care seeking for lower urinary tract symptoms: results from the hospitalised and outpatients' profile and expectations study

Abstract

Background: Few comparisons have been made of health care seeking behaviour for lower urinary tract symptoms (LUTS) between men and women, as well as trends across age groups.

Objective: To investigate the bother from LUTS and effect on health care seeking in both men and women of different age groups and in comparison between the two genders.

Design, setting, and participants: A representative cross section of each of 13 clinics of a general academic hospital, with equal numbers of subjects recruited in each of six design cells that were defined by age (18-40, 41-60, 61-80 yr) and gender.

Intervention: A 2-h in-person interview, conducted by a trained psychologist/interviewer in a clinic office.

Measurements: Severity of LUTS was measured by the International Prostate Symptom Score (IPSS). Treatment seeking was measured by a single item. A bother question was modified to assess overall bother. Impact on quality of life (QoL) was measured by the IPSS QoL question.

Results and limitations: The final study sample comprised 415 patients. More women than men reported the presence of LUTS (85.5% vs 75.2%; p=0.01). LUTS were more bothersome in women (25.4% of women vs 17.6% of men with bother "some" or "a lot"; p=0.02). Severity of LUTS increased with age in both genders (men: p<0.001; women: p=0.03). Bother from LUTS increased as severity of symptoms increased in both genders (p<0.001) but was associated with age only in men (p<0.001). QoL showed similar results as bother. Although men and women had equal prevalence of treatment seeking (27.9% vs 23.7%; p=0.40), men, but not women, were more likely to seek treatment as age (p<0.01) and severity of LUTS (p<0.001) increased. In multivariate logistic regressions, only bother from LUTS was associated with treatment seeking in women, compared with bother, age, and the presence of voiding symptoms in men.

Conclusions: In our hospital-based sample, differences in LUTS frequency, bother, and health care seeking profiles between men and women suggest a different perception and response to LUTS between the two genders.