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Observational Study
. 2018 Apr;199(4):1023-1031.
doi: 10.1016/j.juro.2017.10.035. Epub 2017 Oct 28.

Baseline Lower Urinary Tract Symptoms in Patients Enrolled in LURN: A Prospective, Observational Cohort Study

Anne P Cameron  1 , Christina Lewicky-Gaupp  2 , Abigail R Smith  3 , Brian T Helfand  4 , John L Gore  5 , J Quentin Clemens  6 , Claire C Yang  5 , Nazema Y Siddiqui  7 , H Henry Lai  8 , James W Griffith  2 , Victor P Andreev  3 , Gang Liu  3 , Kevin Weinfurt  9 , Cindy L Amundsen  7 , Catherine S Bradley  10 , John W Kusek  11 , Ziya Kirkali  11 ; Symptoms of Lower Urinary Tract Dysfunction Research Network Study Group
Affiliations
Observational Study

Baseline Lower Urinary Tract Symptoms in Patients Enrolled in LURN: A Prospective, Observational Cohort Study

Anne P Cameron et al. J Urol. 2018 Apr.

Abstract

Purpose: We described and compared the frequency and type of lower urinary tract symptoms reported by men and women at the time that they were recruited from urology and urogynecology clinics into the Symptoms of Lower Urinary Tract Dysfunction Research Network multicenter, prospective, observational cohort study.

Materials and methods: At 6 research sites treatment seeking men and women were enrolled who reported any lower urinary tract symptoms at a frequency more than rarely during the last month on the LUTS (Lower Urinary Tract Symptoms) Tool. At baseline the study participants underwent a standardized clinical evaluation and completed validated questionnaires. Urological tests were performed, including pelvic/rectal examination, post-void residual urine measurement and urinalysis.

Results: A total of 545 women and 519 men were enrolled in the study. Mean ± SD age was 58.8 ± 14.1 years. At baseline nocturia, frequency and a sensation of incomplete emptying were similar in men and women but men experienced more voiding symptoms (90% vs 85%, p = 0.007) and women reported more urgency (85% vs 66%, p <0.001). Women also reported more of any type of urinary incontinence than men (82% vs 51% p <0.001), which was mixed incontinence in 57%. Only 1% of men reported stress incontinence but they had other urinary incontinence, including post-void dribbling in 44% and urgency incontinence in 46%. Older participants had higher odds of reporting symptoms of nocturia and urgency.

Conclusions: In this large, treatment seeking cohort of men and women lower urinary tract symptoms varied widely by gender and age. Men reported more voiding symptoms and nonstress or urgency urinary incontinence while women reported more incontinence overall and urgency. Older participants had greater odds of urgency and nocturia.

Keywords: lower urinary tract symptoms; men's health; overactive; urinary bladder; urinary incontinence; women's health.

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Figures

Figure 1
Figure 1
STROBE Diagram.
Figure 2
Figure 2. ORs (female vs. male) of LUTS symptoms by sex (adjusted for age)
Results from bivariate logistic regression models, with squares denoting ORs comparing female with male participants on the log-odds scale for each item on the LUTS Tool and AUA (AUA items denoted by *). Lines extend to the lower and upper 95% CIs. P-values listed on the right were adjusted for multiple comparisons using the false discovery rate method.
Figure 3
Figure 3. ORs (per 10 year increase in age) of LUTS symptoms by age (adjusted for sex)
Results from bivariate logistic regression models, with squares denoting ORs comparing two participants with a 10-year age difference on the log-odds scale for each item on the LUTS Tool and AUA (AUA items denoted by *). Lines extend to the lower and upper 95% CIs. P-values listed on the right were adjusted for multiple comparisons using the false discovery rate method.
Figure 4
Figure 4. Venn diagram of incontinence subtypes based on LUTS tool responses
Each circle represents the total number of participants with a given type of incontinence. Circle areas are proportional to the number of participants with a given type of incontinence relative to the total number of participants with incontinence. Each overlapping section represents the number of people with multiple (2 or 3) types of incontinence. A) Females; B) Males.
Figure 4
Figure 4. Venn diagram of incontinence subtypes based on LUTS tool responses
Each circle represents the total number of participants with a given type of incontinence. Circle areas are proportional to the number of participants with a given type of incontinence relative to the total number of participants with incontinence. Each overlapping section represents the number of people with multiple (2 or 3) types of incontinence. A) Females; B) Males.
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