Analyzing Why Men Seek Treatment for Lower Urinary Tract Symptoms and Factors Associated With Nonimprovement

Urology. 2015 Nov;86(5):862-7. doi: 10.1016/j.urology.2015.08.006. Epub 2015 Aug 20.

Abstract

Objective: To determine the motivating factor for why men seek urologic care and determine persistence of these symptoms and any factors that influence resolution.

Methods: Men presenting to an outpatient urology clinic with lower urinary tract symptoms (LUTSs) were prospectively evaluated. At each of 2 visits, surveys were administered including the American Urological Association Symptom Index and a chief LUTS complaint (CLC) identification form. On the CLC identification form, symptoms were considered "transient" if only seen at V1 and "persistent" if they were selected at both visits.

Results: Sixty-five percent of the 1240 participants were able to specify a CLC. Among these, nocturia was by far the most common and was found to be persistent in 49% of cases. When comparing the groups of patients who presented with transient verses persistent nocturia, older age (P <.001), diabetes (P = .006), hypertension (P = .033), alpha-blocker use (P = .018), 5-alpha-reductase inhibitor use (P = .008), higher nocturia severity (P <.001), and more severe American Urological Association Symptom Index scores at initial visit (P = .047) were found to be predictors of persistent nocturia.

Conclusion: Most men with LUTS can identify a predominant CLC. Of these, nocturia is the primary CLC of most men and does not improve in almost 50% of those studied. By improving our identification of a predominant CLC and the patient factors that influence both the development and persistence of urinary symptoms, we may start to better evaluate and hopefully focus treatment on the most bothersome urinary symptom.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities / statistics & numerical data*
  • Cohort Studies
  • Disease Progression
  • Follow-Up Studies
  • Health Behavior*
  • Humans
  • Lower Urinary Tract Symptoms / diagnosis*
  • Lower Urinary Tract Symptoms / epidemiology*
  • Lower Urinary Tract Symptoms / therapy
  • Male
  • Nocturia / epidemiology
  • Nocturia / physiopathology
  • Prospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • United States
  • Urodynamics