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J Urol. 2019 Sep;202(3):585-591. doi: 10.1097/JU.0000000000000324. Epub 2019 Aug 8.

Patient Characteristics Associated with More Bother from Lower Urinary Tract Symptoms.

Author information

1
Department of Urology, University of Washington, Seattle, Washington.
2
Arbor Research Collaborative for Health, Ann Arbor, Michigan.
3
Northwestern University Feinberg School of Medicine, Chicago, Illinois.
4
Washington University School of Medicine, St Louis, Missouri.
5
Duke University Medical Center, Durham, North Carolina.
6
Department of Urology, University of Iowa, Iowa City, Iowa.
7
University of Michigan, Ann Arbor, Michigan.
8
National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.

Abstract

PURPOSE:

Some patients continue to have bothersome lower urinary tract symptoms despite treatment. We examined characteristics associated with bother from lower urinary tract symptoms in a prospective cohort.

MATERIALS AND METHODS:

In this 1-year prospective, observational cohort study we obtained data on patients with lower urinary tract symptoms who were seeking care at a total of 6 tertiary care centers in the United States. Participants answered the AUA-SI (American Urological Association Symptom Index) global urinary bother question at study entry and 12 months later. Multilevel logistic and linear regression was used to identify factors associated with worsening bother and bother at 12 months, respectively.

RESULTS:

Of the 756 participants 121 (16%) had worsened lower urinary tract symptom bother during the study period. When adjusted for other variables, worsened lower urinary tract symptom bother was more likely among men who were nonwhite (OR 1.79, 95% CI 0.94-3.40) or who had diabetes (OR 1.68, 95% CI 0.86-3.27) and among women with diabetes (OR 1.77, 95% CI 0.85-3.67), prior treatment of lower urinary tract symptoms (OR 2.58, 95% CI 1.22-5.46) or a higher depression level (OR 1.29, 95% CI 1.10-1.52). Baseline factors associated with more severe bother at 12 months in men included more severe bother at baseline, nonwhite race, worse urinary frequency and incontinence, and higher levels of stress (p <0.05). Among women more severe bother at baseline, urinary urgency and frequency, and worse physical function were associated with more severe bother at 12 months.

CONCLUSIONS:

Urinary symptom severity at baseline, race, depression and psychological stress were associated with the bother of lower urinary tract symptoms in a prospective cohort of men and women treated at tertiary care facilities. These findings may inform the clinical care of patients with bothersome lower urinary tract symptoms and direct providers to better prognosticate for patients with challenging lower urinary tract symptoms cases.

KEYWORDS:

lower urinary tract symptoms; patient reported outcome measures; population characteristics; prognosis; urinary bladder

PMID:
31063049
PMCID:
PMC6697227
DOI:
10.1097/JU.0000000000000324
[Indexed for MEDLINE]
Free PMC Article

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