Do men adapt to lower urinary tract symptoms? An 11-year longitudinal study of male urinary urgency and associated bother

Authors

DOI:

https://doi.org/10.2340/sju.v59.18289

Keywords:

lower urinary tract symptoms, urinary bladder, overactive, cohort studies, observational studies

Abstract

Objective: The study objective is to evaluate prognosis and predictors of bother caused by urinary urgency among middle-aged and older men.

Material and methods: A population-based sample of men born in 1974, 1964, 1954, 1944, 1934 and 1924 was followed-up from 2004 to 2015. The course of urgency and associated bother was evaluated with the Danish Prostatic Symptom Score at baseline and follow-up. Logistic regression was utilized to explore risk factors of increased bother at follow-up.

Results: A total of 2,480 men (39%) who had responded at baseline and follow-up were included in the study. Of them, 1,056 men (43%) had persistent mild urgency and 132 men (5%) persistent moderate or severe urgency at follow-up. The proportions of men experiencing at least moderate bother due to persistent urgency at follow-up were 6% (95% confidence interval 4.5–7.3) of those with mild and 79% (71.7–85.9) of the men with moderate or severe urgency. In multivariable-adjusted logistic regression, moderate to severe urgency was strongly associated with bother (odds ratio, OR 55.2, 95% CI 32.1–95.2). Other predictors of bother included cardiac disease (OR 1.8, 95% CI 1.0–31.1), pulmonary disease (OR 1.9, 95% CI 1.1–3.5) and medical treatment (OR 2.7, 95% CI 1.6–4.6).

Conclusions: Most men with urinary urgency have mild symptoms and bother. Only one out of five men with persistent moderate or severe urgency adapt to the symptoms. Men with a history of medical treatment for lower urinary tract symptoms (LUTS) or impaired cardiopulmonary health are more likely to experience bother from urinary urgency.

Downloads

Download data is not yet available.

References

Lee A, Garraway W, Simpson R, et al. The natural history of untreated lower urinary tract symptoms in middle-aged and elderly men over a period of five years. Eur Urol. 1998;34:325–332.

https://doi.org/10.1159/000019749 DOI: https://doi.org/10.1159/000019749

Berry S, Coffey D, Walsh P, et al. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132:474–479.

https://doi.org/10.1016/S0022-5347(17)49698-4 DOI: https://doi.org/10.1016/S0022-5347(17)49698-4

Gacci M, Vignozzi L, Sebastianelli A, et al. Metabolic syndrome and lower urinary tract symptoms: the role of inflammation. Prostate Cancer Prostatic Dis. 2013;16:101–106.

https://doi.org/10.1038/pcan.2012.44 DOI: https://doi.org/10.1038/pcan.2012.44

Mondul A, Giovannucci E, Platz E. A prospective study of obesity, and the incidence and progression of lower urinary tract symptoms. J Urol. 2014;191:715–721.

https://doi.org/10.1016/j.juro.2013.08.110 DOI: https://doi.org/10.1016/j.juro.2013.08.110

Sexton C, Coyne K, Kopp Z, et al. The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS. BJU Int. 2009;103:12–23.

https://doi.org/10.1111/j.1464-410X.2009.08369.x DOI: https://doi.org/10.1111/j.1464-410X.2009.08369.x

Irwin D, Milsom I, Kopp Z, et al. Prevalence, severity, and symptom bother of lower urinary tract symptoms among men in the EPIC study: impact of overactive bladder. Eur Urol. 2009;56:14–20.

https://doi.org/10.1016/j.eururo.2009.02.026 DOI: https://doi.org/10.1016/j.eururo.2009.02.026

Chrischilles E, Rubenstein L, Chao J, et al. Initiation of nonselective alpha1-antagonist therapy and occurrence of hypotension-related adverse events among men with benign prostatic hyperplasia: a retrospective cohort study. Clin Ther. 2001;23:727–743.

https://doi.org/10.1016/S0149-2918(01)80022-9 DOI: https://doi.org/10.1016/S0149-2918(01)80022-9

Heesakkers J, te Dorsthorst M, Wagg A. Safety and tolerability of fesoterodine in older adult patients with overactive bladder. Can Geriatr J. 2022;25:72–78.

https://doi.org/10.5770/cgj.25.530 DOI: https://doi.org/10.5770/cgj.25.530

Taylor J, Harrison S, Assassa R, et al. The pattern and progression of lower urinary tract symptoms after transurethral prostatectomy compared with those seen in the general population. Eur Urol. 2007;51:1023–1029.

https://doi.org/10.1016/j.eururo.2006.10.012 DOI: https://doi.org/10.1016/j.eururo.2006.10.012

Agarwal A, Eryuzlu L, Cartwright R, et al. What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women. Eur Urol. 2014;65:1211–1217.

https://doi.org/10.1016/j.eururo.2014.01.019 DOI: https://doi.org/10.1016/j.eururo.2014.01.019

Sarma A, Jacobsen S, Girman C, et al. Concomitant longitudinal changes in frequency of and bother from lower urinary tract symptoms in community dwelling men. J Urol. 2002;168:1446–1452.

https://doi.org/10.1097/00005392-200210010-00035 DOI: https://doi.org/10.1097/00005392-200210010-00035

Fukuta F, Masumori N, Mori M, et al. Natural history of lower urinary tract symptoms in Japanese men from a 15-year longitudinal community-based study. BJU Int. 2012;110:1023–1029.

https://doi.org/10.1111/j.1464-410X.2011.10866.x DOI: https://doi.org/10.1111/j.1464-410X.2011.10866.x

Koskimaki J, Hakama M, Huhtala H, et al. Prevalence of lower urinary tract symptoms in Finnish men: a population-based study. Br J Urol. 1998;81:364–369.

https://doi.org/10.1046/j.1464-410x.1998.00565.x DOI: https://doi.org/10.1046/j.1464-410x.1998.00565.x

Pöyhönen A, Häkkinen J, Koskimäki J, et al. Prevalence of hesitancy in 30–80-year-old Finnish men: Tampere Ageing Male Urological Study (TAMUS). BJU Int. 2012;109:1360–1364.

https://doi.org/10.1111/j.1464-410X.2011.10443.x DOI: https://doi.org/10.1111/j.1464-410X.2011.10443.x

Hansen B, Flyger H, Brasso K, et al. Validation of the self-administered Danish Prostatic Symptom Score (DAN-PSS-1) system for use in benign prostatic hyperplasia. Br J Urol. 1995;76:451–458.

https://doi.org/10.1111/j.1464-410X.1995.tb07744.x DOI: https://doi.org/10.1111/j.1464-410X.1995.tb07744.x

D’Ancona C, Haylen B, Oelke M, et al: The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourol Urodyn. 2019;38:433–477.

https://doi.org/10.1002/nau.23897 DOI: https://doi.org/10.1002/nau.23897

Fitzgerald M, Link C, Litman H, et al. Beyond the lower urinary tract: the association of urologic and sexual symptoms with common illnesses. Eur Urol. 2007;52:407–415.

https://doi.org/10.1016/j.eururo.2007.03.014 DOI: https://doi.org/10.1016/j.eururo.2007.03.014

Kim S, Bang W, Choi H. Analysis of the prevalence and associated factors of overactive bladder in adult Korean men. PLoS One. 2017;12: e0175641.

https://doi.org/10.1371/journal.pone.0175641 DOI: https://doi.org/10.1371/journal.pone.0175641

Dempster M, Howell D, McCorry N. Illness perceptions and coping in physical health conditions: a meta-analysis. J Psychosom Res. 2015;79:506–513.

https://doi.org/10.1016/j.jpsychores.2015.10.006 DOI: https://doi.org/10.1016/j.jpsychores.2015.10.006

August K, Sorkin D. Marital status and gender differences in managing a chronic illness: the function of health-related social control. Soc Sci Med. 2010;71:1831–1838.

https://doi.org/10.1016/j.socscimed.2010.08.022 DOI: https://doi.org/10.1016/j.socscimed.2010.08.022

Cornu JN, Ahyai S, Bachmann A, et al. A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol. 2015;67:1066–1096.

https://doi.org/10.1016/j.eururo.2014.06.017 DOI: https://doi.org/10.1016/j.eururo.2014.06.017

Fusco F, Creta M, De Nunzio C, et al. Alpha-1 adrenergic antagonists, 5-alpha reductase inhibitors, phosphodiesterase type 5 inhibitors, and phytotherapic compounds in men with lower urinary tract symptoms suggestive of benign prostatic obstruction: a systematic review and meta-analysis of urodynamic studies. Neurourol Urodyn. 2018;37:1865–1874.

https://doi.org/10.1002/nau.23554 DOI: https://doi.org/10.1002/nau.23554

Michel M, de la Rosette J. Role of muscarinic receptor antagonists in urgency and nocturia. BJU Int. 2005;96:37–42.

https://doi.org/10.1111/j.1464-410X.2005.05651.x DOI: https://doi.org/10.1111/j.1464-410X.2005.05651.x

Gacci M, Sebastianelli A, Spatafora P, et al. Best practice in the management of storage symptoms in male lower urinary tract symptoms: a review of the evidence base. Ther Adv Urol. 2017;10:79–92.

https://doi.org/10.1177/1756287217742837 DOI: https://doi.org/10.1177/1756287217742837

Hall L, Aljuraifani R, Hodges P. Design of programs to train pelvic floor muscles in men with urinary dysfunction: Systematic review. Neurourol Urodyn. 2018;37:2053–2087. DOI: https://doi.org/10.1002/nau.23593

Ouslander J, Griffiths P, McConnell E, et al. Functional incidental training: a randomized, controlled, crossover trial in Veterans Affairs nursing homes. J Am Geriatr Soc 2005;53:1091–1100.

https://doi.org/10.1111/j.1532-5415.2005.53359.x DOI: https://doi.org/10.1111/j.1532-5415.2005.53359.x

Additional Files

Published

2024-02-26

How to Cite

Åkerla, J., Pesonen, J. S., Peltonen, E., Huhtala, H., Häkkinen, J., Koskimäki, J., Tammela, T. L., Auvinen, A., & Pöyhönen, A. (2024). Do men adapt to lower urinary tract symptoms? An 11-year longitudinal study of male urinary urgency and associated bother. Scandinavian Journal of Urology, 59, 47–53. https://doi.org/10.2340/sju.v59.18289

Issue

Section

Original research article