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The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS.

https://arctichealth.org/en/permalink/ahliterature89477
Source
BJU Int. 2009 Apr;103 Suppl 3:4-11
Publication Type
Article
Date
Apr-2009
Author
Coyne Karin S
Wein Alan J
Tubaro Andrea
Sexton Chris C
Thompson Christine L
Kopp Zoe S
Aiyer Lalitha P
Author Affiliation
United BioSource Corporation, Bethesda, MD 20814, USA. Karin.Coyne@unitedbiosource.com
Source
BJU Int. 2009 Apr;103 Suppl 3:4-11
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Anxiety Disorders - epidemiology - etiology
Depressive Disorder - epidemiology - etiology
Epidemiologic Methods
Europe - epidemiology
Female
Health Surveys
Humans
Male
Middle Aged
Prevalence
Psychiatric Status Rating Scales
Quality of Life
Questionnaires
Severity of Illness Index
United States - epidemiology
Urination Disorders - epidemiology - psychology
Abstract
OBJECTIVE: To evaluate the impact of lower urinary tract symptoms (LUTS) on urinary-specific health-related quality of life (HRQL), generic health indices, depression and anxiety in a population-representative sample of men and women, as research has linked LUTS with reduced HRQL and depression, but little is known about the effects of individual LUTS on HRQL, depression and anxiety. SUBJECTS AND METHODS: A cross-sectional population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Participants rated the frequency and symptom-specific bother of individual LUTS and condition-specific HRQL, generic health status, anxiety and depression. Descriptive statistics were used to evaluate outcome differences by International Continence Society LUTS subgroups; logistic regressions were used to determine associations of LUTS and perception of bladder problems, anxiety and depression. RESULTS: The overall survey response rate was 59.2%; 30 000 subjects (14 139 men and 15 861 women) participated. Men and women with LUTS in the all LUTS subgroup (storage, voiding and postmicturition) reported the lowest levels of HRQL and highest levels of anxiety and depression, with 35.9% of men and 53.3% of women meeting self-reported screening criteria for clinical anxiety (Hospital Anxiety and Depression Scale, HADS, Anxiety > or =8), and 29.8% of men and 37.6% of women meeting self-reported criteria for clinical depression (HADS Depression > or =8). In both men and women, storage symptoms were significantly associated with greater perceived bladder impact, whereas voiding symptoms were not. Significant predictors of anxiety included nocturia, urgency, stress urinary incontinence, leaking during sexual activity, weak stream and split stream in women; and nocturia, urgency, incomplete emptying and bladder pain in men. For depression, weak stream, urgency and stress urinary incontinence were significant for women, and perceived frequency and incomplete emptying were significant for men. CONCLUSION: The negative effect of LUTS is apparent across several domains of HRQL and on overall perception of bladder problems, general health status and mental health. The high level of psychiatric morbidity in patients with multiple LUTS has important implications for treatment and highlights the need for further research to pinpoint specific mechanisms underlying this association.
PubMed ID
19302497 View in PubMed
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The impact of lower urinary tract symptoms on male sexual health: EpiLUTS.

https://arctichealth.org/en/permalink/ahliterature89474
Source
BJU Int. 2009 Apr;103 Suppl 3:33-41
Publication Type
Article
Date
Apr-2009
Author
Wein Alan J
Coyne Karin S
Tubaro Andrea
Sexton Chris C
Kopp Zoe S
Aiyer Lalitha P
Author Affiliation
Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Source
BJU Int. 2009 Apr;103 Suppl 3:33-41
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Epidemiologic Methods
Europe - epidemiology
Humans
Male
Men's health
Middle Aged
Prostatic Hyperplasia - complications - epidemiology
Prostatism - complications - epidemiology
Quality of Life
Questionnaires
Severity of Illness Index
Sexual Behavior
Sexual Dysfunction, Physiological - epidemiology - etiology
United States - epidemiology
Abstract
OBJECTIVE: To evaluate the association between International Continence Society categories of lower urinary tract symptoms (LUTS; storage, voiding, and postmicturition) and individual LUTS (associated with decreased sexual activity and sexual satisfaction in men) with erectile dysfunction (ED), ejaculatory dysfunction (EjD) and premature ejaculation (PE). SUBJECTS AND METHODS: The impact of LUTS on men's sexual health was captured as part of a cross-sectional epidemiological study to assess the prevalence LUTS among men and women aged > or =40 years in the USA, the UK and Sweden. RESULTS: The analysis included 11 834 men with a mean age of 56.1 years, 71% of whom reported being currently sexually active. The primary reason for not being sexually active was no partner (35%), followed by personal health (23%) and no desire (23%). Of the men, 26% had mild to severe ED, 7% had EjD, and 16% PE. Men with multiple LUTS had more severe ED and more frequent EjD and PE. Logistic regression analysis showed that greater age, hypertension, diabetes, depression, urgency with fear of leaking, and leaking during sexual activity were significantly associated with ED. The results were similar in the logistic regression analysis for EjD, whereas being younger and the absence of prostatitis were significantly associated with PE, as were the presence of terminal dribble, incomplete emptying, and split stream. CONCLUSION: LUTS are associated with common sexual dysfunctions in men. The results of this study highlight the importance of assessing the sexual health of men presenting with LUTS.
PubMed ID
19302500 View in PubMed
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The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS.

https://arctichealth.org/en/permalink/ahliterature89476
Source
BJU Int. 2009 Apr;103 Suppl 3:12-23
Publication Type
Article
Date
Apr-2009
Author
Sexton Chris C
Coyne Karin S
Kopp Zoe S
Irwin Debra E
Milsom Ian
Aiyer Lalitha P
Tubaro Andrea
Chapple Christopher R
Wein Alan J
Author Affiliation
United BioSource Corporation, Bethesda, MD 20814, USA. chris.sexton@unitedbiosource.com
Source
BJU Int. 2009 Apr;103 Suppl 3:12-23
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Epidemiologic Methods
Europe - epidemiology
Female
Humans
Male
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Prevalence
Quality of Life
Questionnaires
Severity of Illness Index
United States - epidemiology
Urination Disorders - epidemiology - therapy
Abstract
OBJECTIVE: To assess the (i) the overlap between voiding, storage, and postmicturition symptoms; and (ii) the relative effect of bother and implications for treatment seeking within these symptom groups, using data from the EpiLUTS study. SUBJECTS AND METHODS: This cross-sectional population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Participants were asked to rate the frequency and symptom-specific bother of individual LUTS. Descriptive statistics were used to examine differences in International Continence Society LUTS subgroups. Logistc regressions were used with treatment seeking as the dependent variable and the bother of individual symptoms as predictors. RESULTS: The survey response rate was 59%. The sample included 30,000 participants (14,139 men and 15,861 women); 71% of men and 75% of women reported at least one LUTS, and about half reported LUTS from more than one symptom group. Rates of bother were greatest for those who reported multiple storage, voiding and postmicturition LUTS (men 83%, women 89%). Less than a third of participants with LUTS from all three groups reported seeking treatment. Consistent correlates of treatment seeking across genders included bother due to weak stream, incomplete emptying, perceived daytime frequency, nocturia and urgency. There were also significant associations for several types of incontinence, most commonly stress incontinence in women and leaking during sexual activity in men. Despite high rates of symptom overlap and symptom-specific bother, few participants sought treatment for LUTS. CONCLUSION: Common conditions such as BPH and OAB are treatable, and clinicians should proactively ask patients about urinary symptoms. Given the many types of LUTS that patients experience, it is imperative that clinicians assess all LUTS to ensure that appropriate treatments are prescribed.
PubMed ID
19302498 View in PubMed
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The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study.

https://arctichealth.org/en/permalink/ahliterature89680
Source
BJU Int. 2009 Aug;104(3):352-60
Publication Type
Article
Date
Aug-2009
Author
Coyne Karin S
Sexton Chris C
Thompson Christine L
Milsom Ian
Irwin Debra
Kopp Zoe S
Chapple Christopher R
Kaplan Steven
Tubaro Andrea
Aiyer Lalitha P
Wein Alan J
Author Affiliation
United BioSource Corporation, Center for Health Outcomes Research, Bethesda, MD 20814, USA. karin.coyne@unitedbiosource.com
Source
BJU Int. 2009 Aug;104(3):352-60
Date
Aug-2009
Language
English
Publication Type
Article
Abstract
OBJECTIVE: To estimate and compare the prevalence and associated bother of lower urinary tract symptoms (LUTS) in the general populations of the USA, UK and Sweden using current International Continence Society (ICS) definitions, as no previous population-based studies evaluating the prevalence of LUTS in the USA, using the 2002 ICS definitions, have been conducted. SUBJECTS AND METHODS: This cross-sectional, population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Members of Internet-based panels were randomly selected to receive an e-mailed invitation to participate. If interested, respondents selected a link to an informed consent page, followed by the survey. Participants were asked to rate how often they experienced individual LUTS during the previous 4 weeks, on a five-point Likert scale, and, if experienced, how much the symptom bothered them. Descriptive statistics were used to summarize and present the data. RESULTS: Responses rates for the USA, the UK and Sweden were 59.6%, 60.6% and 52.3%, respectively, with a final sample of 30,000 (USA 20,000; UK 7500; Sweden 2500). The mean age (range) of the participants was 56.6 (40-99) years; the mean percentages for race were 82.9% white, 6.7% black, 6.0% Hispanic and 4.4% Asian/other. The prevalence of LUTS was defined by two symptom frequency thresholds, i.e. at least 'sometimes' and at least 'often' for all LUTS except incontinence, where frequency thresholds were at least 'a few times per month' and at least 'a few times per week'. The prevalence of at least one LUTS at least 'sometimes' was 72.3% for men and 76.3% for women, and 47.9% and 52.5% for at least 'often' for men and women, respectively. For most LUTS, at least half of the participants were bothered 'somewhat' or more using a frequency threshold of at least 'sometimes'. For a threshold of at least 'often', 'somewhat' or more bother was reported by > or =70% of participants except for terminal dribble in men and split stream in women. CONCLUSION: In this large population study of three countries, LUTS are highly prevalent among men and women aged >40 years. In general, LUTS experienced 'often' or more are bothersome to most people.
PubMed ID
19281467 View in PubMed
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Risk factors and comorbid conditions associated with lower urinary tract symptoms: EpiLUTS.

https://arctichealth.org/en/permalink/ahliterature89475
Source
BJU Int. 2009 Apr;103 Suppl 3:24-32
Publication Type
Article
Date
Apr-2009
Author
Coyne Karin S
Kaplan Steven A
Chapple Christopher R
Sexton Chris C
Kopp Zoe S
Bush Elizabeth N
Aiyer Lalitha P
Author Affiliation
United BioSource Corporation, Bethesda, MD 20814, USA. Karin.Coyne@unitedbiosource.com
Source
BJU Int. 2009 Apr;103 Suppl 3:24-32
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Epidemiologic Methods
Europe - epidemiology
Female
Humans
Male
Middle Aged
Prevalence
Quality of Life
Questionnaires
Risk factors
United States - epidemiology
Urination Disorders - complications - epidemiology
Abstract
OBJECTIVE: To explore the risk factors and comorbid conditions associated with subgroups of lower urinary tract symptoms (LUTS) in men and women aged > or =40 years in three countries, using data from the EpiLUTS study, as LUTS are common amongst men and women and increase in prevalence with age. SUBJECTS AND METHODS: This cross-sectional, population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Participants were asked to rate how often they experienced individual LUTS during the past 4 weeks on a 5-point Likert scale. Eight LUTS subgroups were created. Descriptive statistics and logistic regressions within each LUTS subgroup were used to assess the data. RESULTS: The survey response rate was 59%. The final sample was 30,000 (men and women). The voiding + storage + postmicturition (VSPM) group reported the highest rates of comorbid conditions for both men and women, and the fewest were reported in the no/minimal LUTS and the postmicturition-only groups. Increasing age was associated with increasing LUTS in men, but not in women. Comorbid conditions significantly associated with the VSPM group were arthritis, asthma, chronic anxiety, depression, diabetes (men only), heart disease, irritable bowel syndrome, neurological conditions, recurrent urinary tract infection, and sleep disorders. Risk factors, such as body mass index, exercise level and smoking, played less of a role, except for childhood nocturnal enuresis, which was significantly associated with most LUTS subgroups. CONCLUSION: In this large population study, many comorbid conditions and risk factors were significantly associated with LUTS among both men and women. Further longitudinal investigations of the associations noted here would help physicians to understand the pathophysiology of LUTS and comorbid conditions, and provide clinical guidelines for patient management of comorbid conditions sharing common pathophysiological pathways.
PubMed ID
19302499 View in PubMed
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