Factors related to lower urinary tract symptoms among a sample of employed women in Taipei

Association of Pelvic Floor Disorders, Perceived Psychological Stress, and Military Service in U.S. Navy Servicewomen: A Cross-Sectional Survey

IMPORTANCE

Pelvic floor disorders (PFDs) are linked to psychological stress and decreased work performance in civilian populations. Higher psychological stress is reported in female active-duty servicewomen (ADSW), which affects military readiness.

OBJECTIVE

This study sought to associate PFDs, work-related challenges, and psychological stress in ADSW.

STUDY DESIGN

We conducted a single-site, cross-sectional survey of ADSW seeking care in the urogynecology, family medicine, and women's health clinics between December 2018 and February 2020 using validated questionnaires to determine the prevalence of PFDs and the association with psychological stress, performance of military duties, and continued military service.

RESULTS

One hundred seventy-eight U.S. Navy ADSW responded; most were seeking care for PFDs. The reported prevalence rates of PFDs were as follows: urinary incontinence, 53.7%; pelvic organ prolapse, 16.3%; fecal incontinence, 73.2%; and interstitial cystitis/bladder pain syndrome, 20.3%. Active-duty servicewomen with PFDs were more likely to have higher psychological stress scores (22.5 ± 3.7 vs 20.5 ± 4.2, P = 0.002) and body composition failures (22.0% vs 7.3%, P = 0.012), yet more strongly consider remaining on active service if they reported urinary incontinence (22.8% vs 1.8%) or interstitial cystitis/bladder pain syndrome (19.5% vs 1.8%; all P ≤ 0.001). No significant differences were noted in physical fitness failures or other military duties.

CONCLUSIONS

For these U.S. Navy ADSW with PFDs, there was no significant difference in duty performance but reported psychological stress levels were higher. The presence of PFD was associated with women more strongly considering ongoing military service compared with other factors such as family, job, or career path.

Work-Related Factors Associated With the Pelvic Floor Dysfunction Among a Sample of Female Nurses in China

BACKGROUND

Female nurses are a high-risk group for pelvic floor dysfunction (PFD). Predictors of female nurses' PFD among work-related factors are not well known. The aim of this study was to investigate the prevalence of PFD and its association with workplace conditions among female nurses in China.

METHODS

An online cross-sectional survey was conducted in May 2021. A sample of 380 registered nurses working in six tertiary hospitals in Nanjing, China participated. Data on individual characteristics, work-related factors, the Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire-7 were used.

FINDINGS

The overall prevalence of PFD among nurses was 83.9%, with 43.9% of participants experiencing pelvic organ prolapse, 66.6% experiencing anorectal dysfunction and 60.5% experiencing lower urinary tract symptoms. In terms of work-related factors, PFD was associated with heavy lifting, pushing, and carrying at work, delayed toileting at work and fluid intake. Female nurses with PFD reported lower quality of life (QoL) relative to nurses without PFD.

CONCLUSIONS/APPLICATION TO PRACTICE

Our findings provide initial insights into workplace conditions that promote PFD among female nurses. Occupational health nurses should consider providing educational information for female workers who are potentially at risk for PFD and consider integrating screening of PFD into practice.

Occupational risk factors associated with lower urinary tract symptoms among female workers: a systematic review

A systematic review was performed aiming to identify the various occupational risk factors of lower urinary tract symptoms (LUTS) among female workers. A systematic, comprehensive literature search of PubMed, Embase and Cochrane Library databases was conducted to identify studies published until 24 November 2021, evaluating the possible occupational risk factors of LUTS among female workers. Two reviewers assessed all articles retrieved through a computerised search for eligibility using predetermined criteria. Data on the first author, publication year, country, study design, participants, identified occupational risk factors, outcome variables and main results were extracted from the selected articles. The Newcastle-Ottawa Quality Assessment Scale guidelines were adopted to estimate the quality scores. Overall, our search yielded a total of 16 articles suitable for review. The occupational risk factors identified in the studies were strenuous physical demand and activity, prolonged sitting, occupational stress, shift work, limited use of the toilet at work and other occupational environments (eg, an unclean and uncomfortable workplace, dangerous job and probability of accidents, feeling pressed for time and awkward position for long periods). The findings of this review may raise awareness regarding the risk of LUTS among female workers with these factors. From an occupational health perspective, the implementation of tailored prevention strategies based on these occupational factors may prevent female workers from developing LUTS.PROSPERO registration numberCRD42022316728.

Urination behaviours of senior citizens in five Chinese cities: Results of a cross-sectional survey

AIM

To investigate the urination behaviours of senior citizens in China.

METHODS

Stratified random sampling was used to recruit senior citizens who met the inclusion criteria from five cities in China. After training by researchers, participants recorded their urination behaviours in real time by using the validated 7-day 24-hour urination behaviour record, which consisted of frequency of urination, time of urination, urinary urgency and urine colour.

RESULTS

Of the 551 recruited participants, 524 (233 male and 291 female) completed the survey, yielding a completion rate of 95.1%. The median frequency of urination was 7.4 times per day. The frequency of urination was highest among participants in Guangzhou, at 8.0 times per day (χ²  = 29.356; P < .001), and participants in the first percentile body mass index group, at 8.0 times per day (χ²  = 10.344; P = .016). The percentage of participants who urinated >7 times during the day was 44.3%. The percentage of participants who urinated ≥1 time at night was 77.5%. The number of times participants reported feeling no urge to urinate, a strong urge to urinate and an uncomfortable urge to urinate accounted for 59.7%, 62.8% and 24.8% of all records of urinary urgency, respectively. Instances of patients having no urge to urinate, a strong urgent to urinate and an uncomfortable urge accounted for 16.1%, 13.3% and 2.9% of all instances of urination, respectively. The number of times participants whose urine was yellow and dark yellow accounted for 69.1% and 18.9% of all records of urine colour, respectively. Urine with yellow and dark yellow colour accounted for 13.0% and 1.5%, respectively.

CONCLUSION

Unhealthy urination behaviours, including urinating at night and holding back urine, were common among senior citizens. This result can provide information for the prevention and control of urinary system diseases.

Effects of an education program on toileting behaviors and bladder symptoms in overactive bladder patients with type 2 diabetes: A randomized clinical trial

BACKGROUND

Overactive bladder is more common in patients with type 2 diabetes than in those without diabetes. Many patients with diabetes adopt unhealthy toileting behaviors to empty their bladder that may contribute to the onset or worsening of overactive bladder.

OBJECTIVE

To investigate whether an education program targeting toileting behaviors is effective for helping overactive bladder patients with type 2 diabetes in terms of adopting healthy toileting behaviors, improving bladder symptoms, and enhancing quality of life.

DESIGN

The study was a parallel, pragmatic, open-label randomized trial.

SETTINGS

The trial was conducted in a hospital-based endocrinology outpatient department in Jinan, China.

PARTICIPANTS

A total of 104 patients were randomly assigned to a 6-week education program or a control group.

METHODS

Primary outcomes included toileting behaviors and bladder symptoms, including dry/wet overactive bladder and severity of urgency. Secondary outcomes were overactive bladder-specific and general quality of life. The patients were reassessed on the outcome variables at the end of the intervention and at 3 months and 6 months following the intervention. The analysis followed the intent-to-treat principle. To account for the longitudinal data with repeated measures, group comparisons for continuous outcomes were evaluated using linear mixed models. Group differences in binary outcomes were examined using mixed-effects logit models.

RESULTS

Compared with the control group, the education program group showed significant changes in three unhealthy toileting behaviors: premature voiding (-0.7, p < 0.001), place preference for voiding (-0.5, p = 0.007), and delayed voiding (-0.2, p = 0.011). The program significantly relieved the bladder symptoms (-2.2, p < 0.001) and decreased the probability of having wet overactive bladder (-0.3, p < 0.001) and the severity of urgency (-0.4, p < 0.001). It also significantly improved the overactive bladder-specific quality of life by 10.8 points (p = 0.001). Regarding patients' general quality of life, the physical aspect was enhanced by 3.0 points (p = 0.049); however, no effect on the mental well-being aspect was observed.

CONCLUSIONS

Among overactive bladder patients with type 2 diabetes, the 6-week education program targeting toileting behaviors resulted in the adoption of healthy toileting behaviors, relief of bladder symptoms and improvement in quality of life in the 6 months following the intervention compared with routine care alone. The education program was highly successful and may represent an effective, acceptable, feasible, and safe intervention for improving bladder health and quality of life during diabetes care, given that the toileting behavioral changes were maintained during the 6-month follow-up period.

Urinary Urgency in Working Women: What Factors Are Associated with Urinary Urgency Progression?

BACKGROUND

Urinary urgency is the primary symptom of overactive bladder (OAB). This study aimed to identify targets for effective intervention to delay progression of urinary urgency.

MATERIAL AND METHODS

Secondary analyses of data from a study conducted with female employees of a large academic medical center were conducted. Women were ≥18 years and nonpregnant at the time of the survey. An online questionnaire obtained demographic information, presence of lower urinary tract symptoms, and toileting behaviors. Bivariate analyses and multivariate logistic regression were applied to explore factors related to different stages of urinary urgency.

RESULTS

Four stages of urinary urgency were constructed: (1) Stage 1: no urinary symptoms (n = 20), (2) Stage 2: continent but urinary urgency reported (n = 19), (3) Stage 3: nonsevere urgency urinary incontinence (UUI) (incontinent but leakage ≤1/day, n = 74); and (4) Stage 4: severe UUI (leakage ≥1/day, n = 26). In multivariate analyses, older women were more likely to be in Stage 3 than in Stage 2 (aOR 1.053, 95% CI 1.012-1.096). Women who lost urine with defecation were more likely to be in Stage 4 than Stage 3 (aOR 3.828, 95% CI 1.921-7.629). Women who habitually strained to empty the bladder faster were more likely to be in Stage 4 than in Stage 3 (aOR 6.588, 95% CI 1.317-32.971).

CONCLUSIONS

Losing urine with defecation and making the bladder empty faster by pushing down should be explored as intervention targets to prevent women from progressing from Stage 3 to Stage 4.

Psychological and Physical Environmental Factors in the Development of Incontinence in Adults and Children: A Comprehensive Review

The aim of this review was to identify etiological environmental factors related to incontinence in children and adults. A variety of etiological environmental factors for the development of incontinence were identified. In children, these encompass stressful life events and trauma, family dysfunction, parental psychopathology, school-related stressors, toilet or "potty" training, fluid consumption habits, housing conditions, and the availability of toilets. In adults, physical exercise, obesity, working conditions, fluid intake, and the availability of toilets play a role. Intervening variables such as hormonal variations due to work shifts have also been identified as influencing the likelihood of incontinence. Current research suggests that environmental factors influence the development of incontinence in children and adults. The interactions between biological factors, the immediate environment, and intervening variables need to be explored in greater detail. Practical solutions to reduce barriers to adequate fluid intake and healthy toileting habits should be implemented in school and work settings.

Toileting behaviours and lower urinary tract symptoms among female nurses: A cross-sectional questionnaire survey

BACKGROUND

Unhealthy toileting behaviours exist among women, and lower urinary tract symptoms have a high prevalence and significant effects on quality of life. However, the relationship between toileting behaviours and lower urinary tract symptoms is unclear.

OBJECTIVES

This study aimed to investigate the prevalence of lower urinary tract symptoms among female nurses, and the association between toileting behaviours and lower urinary tract symptoms.

DESIGN

A cross-sectional stratified cluster sampling study.

PARTICIPANTS

A total of 636 female clinical nurses from tertiary hospitals in Jinan (the capital city of Shandong Province, China).

METHODS

The Toileting Behaviour-Women's Elimination Behaviours and the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms scales were used to assess the participants' toileting behaviours and lower urinary tract symptoms, respectively. Multiple linear regression analysis was used to evaluate the association between toileting behaviours and lower urinary tract symptoms.

RESULTS

Unhealthy toileting behaviours were common among the female nurses, with delayed voiding being the unhealthiest toileting behaviour, which was followed by place and position preference for voiding. Nearly 68% of the female nurses had at least one lower urinary tract symptom, nearly 50% had incontinence symptoms, 40% had filling symptoms, and 18% had voiding symptoms. Unhealthy toileting behaviours (premature voiding, delayed voiding, and straining to void) were positively associated with lower urinary tract symptoms. However, lower urinary tract symptoms were not significantly associated with voiding place or position preference. Among the control variables, being married or having a history of a urinary tract infection was associated with lower urinary tract symptoms. Having a higher income and regular menstrual period were negatively associated with lower urinary tract symptoms. Compared with vaginal delivery, caesarean delivery had a protective association with lower urinary tract symptoms.

CONCLUSION

Lower urinary tract symptoms among female nurses should not be overlooked, because their prevalence among female clinical nurses exceeded that among the general population of women. These findings highlight the importance of avoiding unhealthy toileting behaviours (especially premature voiding, delayed voiding, and straining to void), as these unhealthy toileting behaviours were significantly associated with susceptibility to lower urinary tract symptoms.

Toileting behaviour and related health beliefs among Chinese female nurses

AIMS

To investigate the toileting behaviours that female nurses used to empty their bladders, health beliefs related to toileting behaviour and the relationships between the health beliefs and toileting behaviour based on the Health Belief Model.

METHODS

A stratified cluster sampling strategy was used to recruit 636 female nurses from three tertiary hospitals in China. Reliable and valid questionnaires were used to assess female nurses' toileting behaviour and health beliefs related to toileting behaviour. The structural equation model was applied to explore the relationships between health belief constructs and toileting behaviour.

RESULTS

The most common unhealthy toileting behaviour was that of delayed voiding. More than half of the nurses (53.6%) often or always delayed emptying their bladders when they were busy. Approximately one-third of female nurses often or always crouched over the toilet to empty their bladders when not at home. Nearly two-thirds often or always worried about the cleanliness of public toilets. Of all the participants, 67.5% of female nurses had at least one type of lower urinary tract symptom (LUTS); however, the majority did not believe that they were susceptible to these symptoms. Moreover, they had misconceptions that premature voiding would reduce the risk, relieve the symptoms and prevent the recurrence of LUTS.

CONCLUSIONS

Many female nurses engaged in unhealthy toileting behaviours and might not know what types of toileting behaviours are healthy. Nurses play an important role in patient education and are a major source of health information for society. It is particularly important to look more closely at toileting behaviour among nurses and implement education and training to promote healthy toileting behaviour and, in turn, optimise bladder health.

Urinary incontinence in women in relation to occupational status

Through this cross-sectional study the authors explore urinary incontinence in women in relation to occupational status and environment. Data from the fourth Korea National Health and Nutrition Examination Survey (2008-2009) were used (n = 5,928) excluding those aged under 19 or over 65 years, male, with renal disease, and with missing data. Urinary incontinence was prevalent in working women. Compared to unemployed women, the adjusted odds ratio (95% confidence intervals) for women working in services/sales was 1.62 (1.21-2.19); for paid workers was 1.81 (1.20-2.73); and for self-employed workers was 1.46 (1.05-2.03). Compared to unemployed women, the adjusted odds ratio for working women with a daytime work schedule was 2.14 (1.18-3.87), while for those with evening work schedules, it was 1.35 (1.05-1.74). Urinary incontinence was significantly associated with various occupational environments: an unclean and uncomfortable workplace, dangerous job and probability of accidents, feeling pressed for time, awkward position for long periods, and carrying heavy weights. These findings suggest that urinary incontinence was prevalent in working women and was associated with occupational status and working environment. Therefore, improving occupational status and environment for working women-such as modifying the working schedule, posture, and workplace atmosphere-are needed to prevent urinary incontinence.

Caffeine enhances micturition through neuronal activation in micturition centers

Caffeine may promote incontinence through its diuretic effect, particularly in individuals with underlying detrusor overactivity, in addition to increasing muscle contraction of the bladder smooth muscle. Caffeine may also affect bladder function via central micturition centers, including the medial preoptic area, ventrolateral periaqueductal gray, and pontine micturition center. However, the biochemical mechanisms of caffeine in central micturition centers affecting bladder function remain unclear. In the present study, the effects of caffeine on the central micturition reflex were investigated by measuring the degree of neuronal activation, and by quantifying nerve growth factor (NGF) expression in rats. Following caffeine administration for 14 days, a urodynamic study was performed to assess the changes to bladder function. Subsequently, immunohistochemical staining to identify the expression of c‑Fos and NGF in the central micturition areas was performed. Ingestion of caffeine increased bladder smooth muscle contraction pressure and time as determined by cystometry. Expression levels of c‑Fos and NGF in all central micturition areas were significantly increased following the administration of caffeine. The effects on contraction pressure and time were the most potent and expression levels of c‑Fos and NGF were greatest at the lowest dose of caffeine. These results suggest that caffeine facilitates bladder instability through enhancing neuronal activation in the central micturition areas.

Prevalence, associated factors, and relationship to quality of life of lower urinary tract symptoms: a cross-sectional, questionnaire survey of cancer patients

BACKGROUND

Few studies conducted outside of Asia have shown that lower urinary tract symptoms (LUTS) could be a concern for cancer patients. This gap necessitates more research on LUTS among cancer patients in Asia, particularly regarding associated factors and the relationship between quality of life and LUTS.

OBJECTIVES

This study investigates the prevalence, associated factors, and relationship to quality of life of LUTS based on a sample of cancer patients.

DESIGN

A cross-sectional, questionnaire survey.

SETTINGS/PARTICIPANTS

This study was conducted at two oncology outpatient departments in two hospitals in Taiwan, and included 134 Asian cancer patients.

METHODS

We collected information about each participant's individual characteristics, personal habits, LUTS, and quality of life by using a questionnaire. We calculated descriptive statistics to demonstrate the distribution of collected information, and used multivariate logistic regression to identify the factors associated with LUTS. We used Student's t-test to compare the mean quality of life scores for participants with and without LUTS.

RESULTS

Ninety-nine (73.9%) participants experienced at least one type of LUTS, and the prevalence rates for various types of LUTS ranged from 3.7% to 52.2%. Radiotherapy and the time since the diagnosis of cancer were associated with LUTS. Participants with LUTS reported lower quality of life scores than participants without LUTS.

CONCLUSIONS

The high prevalence of LUTS suggests that cancer treatment might be linked to LUTS, which in turn has a negative effect on a patient's quality of life. These results suggest that future research should involve studies in larger, more homogeneous samples. Health care providers should monitor the presence of LUTS and deliver the management and treatments of LUTS to optimise cancer patients' quality of life.

The prevalence and causes of nocturia

PURPOSE

Nocturia is a troubling condition with implications for daytime functioning. However, it often goes unreported. Many prevalence studies exist but differences in populations and definitions of nocturia render assimilation of the data difficult. This review provides an overview of the nocturia prevalence literature.

MATERIALS AND METHODS

A PubMed® search was performed to identify articles published in English from 1990 to February 2009 reporting nocturia prevalence in community based populations. Rates reported as overall data, and by age and by gender, were plotted for comparison.

RESULTS

A total of 43 relevant articles were identified. Prevalence rates in younger men (20 to 40 years) were 1 or more voids in 11% to 35.2% and 2 or more voids in 2% to 16.6%. Prevalence rates in younger women were 1 or more voids in 20.4% to 43.9% and 2 or more voids in 4.4% to 18%. In older men (older than 70 years) rates were 1 or more void in 68.9% to 93% and 2 or more voids in 29% to 59.3%. In older women rates were 1 or more void in 74.1% to 77.1% and 2 or more voids in 28.3% to 61.5%. Therefore, in practice up to 1 in 5 or 6 younger people consistently wake to void at least twice each night. In some studies younger women appeared more likely to be affected than men. Up to 60% of older people void 2 or more times nightly.

CONCLUSIONS

Nocturia is common across populations. It is most prevalent in older people but it also affects a significant proportion of younger individuals. Clinicians should be alert to the possibility that nocturia may impact the sleep, quality of life and overall health of their patients. Since the condition is highly multifactorial, frequency-volume charts are invaluable tools for the diagnosis of underlying factors and for treatment selection.

High frequency of overlap between functional dyspepsia and overactive bladder

BACKGROUND

Overactive bladder syndrome (OAB) is defined as a symptom complex comprising urgency, with or without urge incontinence, and usually frequency and nocturia. The association between irritable bowel syndrome (IBS) and bladder symptoms has been reported. This study is designed to investigate whether functional dyspepsia (FD), like IBS, is associated with OAB.

METHODS

A web surveys containing questions about OAB, FD, IBS, and demographics were completed by 5494 public individuals (2302 men and 3192 women) who have no history of severe illness. The prevalence and overlap of OAB, FD, and IBS were examined.

KEY RESULTS

Among participants with FD, 20.5% could also be diagnosed with OAB (odds ratio [OR]: 2.85; 95% confidence interval [CI]: 2.21-3.67). Although concomitant FD and IBS were more strongly associated with OAB (OR: 4.34; 95% CI: 2.81-6.73), OAB was also highly prevalent among participants with FD but without IBS (OR: 3.09; 95% CI: 2.29-4.18). Among participants with FD, an overlapping OAB condition was more prevalent in those with both postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) (OR: 3.75; 95% CI: 2.48-5.67) than in those with PDS or EPS alone. Among participants with OAB, the severity of bladder symptoms was greater in participants with dyspeptic symptoms than without them.

CONCLUSIONS & INFERENCES

Overactive bladder syndrome is common among FD patients, even if they do not have IBS. To improve FD patients' quality of life, it will be important to provide management for OAB.

Effect of caffeine on bladder function in patients with overactive bladder symptoms

Objectives:

To evaluate the effect of caffeine at the dose of 4.5 mg/kg on bladder function in overactive bladder (OAB) adults.

Materials and Methods:

Nine women and three men aged 21-40 years with OAB symptoms were included. Each subject drank 8 ml/kg of water with and without caffeine at two separate sessions. Cystometry and uroflowmetry were performed 30 minutes after each drink. The effects of caffeine on urodynamic parameters were compared.

Results:

After caffeine ingestion, the mean volume at bladder filling phase decreased at first desire to void and normal desire to void (P<0.05), compared to the mean volume after taking water (control) drink. The mean volume at strong desire to void, urgency and maximum cystometric capacity also tended to decrease. No change in the detrusor pressure at filling phase was found. At voiding phase, the maximal flow rate, average flow rate and voided volume were increased (P<0.05). The urine flow time and time to maximal flow rate were not changed.

Conclusion:

Caffeine at 4.5 mg/kg caused diuresis and decreased the threshold of sensation at filling phase, with an increase in flow rate and voided volume. So, caffeine can promote early urgency and frequency of urination. Individuals with lower urinary tract symptom should avoid or be cautious in consuming caffeine containing foodstuffs.

The prevalence and causes of nocturia

PURPOSE

Nocturia is a troubling condition with implications for daytime functioning. However, it often goes unreported. Many prevalence studies exist but differences in populations and definitions of nocturia render assimilation of the data difficult. This review provides an overview of the nocturia prevalence literature.

MATERIALS AND METHODS

A PubMed search was performed to identify articles published in English from 1990 to February 2009 reporting nocturia prevalence in community based populations. Rates reported as overall data, and by age and by gender, were plotted for comparison.

RESULTS

A total of 43 relevant articles were identified. Prevalence rates in younger men (20 to 40 years) were 1 or more voids in 11% to 35.2% and 2 or more voids in 2% to 16.6%. Prevalence rates in younger women were 1 or more voids in 20.4% to 43.9% and 2 or more voids in 4.4% to 18%. In older men (older than 70 years) rates were 1 or more void in 68.9% to 93% and 2 or more voids in 29% to 59.3%. In older women rates were 1 or more void in 74.1% to 77.1% and 2 or more voids in 28.3% to 61.5%. Therefore, in practice up to 1 in 5 or 6 younger people consistently wake to void at least twice each night. In some studies younger women appeared more likely to be affected than men. Up to 60% of older people void 2 or more times nightly.

CONCLUSIONS

Nocturia is common across populations. It is most prevalent in older people but it also affects a significant proportion of younger individuals. Clinicians should be alert to the possibility that nocturia may impact the sleep, quality of life and overall health of their patients. Since the condition is highly multifactorial, frequency-volume charts are invaluable tools for the diagnosis of underlying factors and for treatment selection.

Risk factors and comorbid conditions associated with lower urinary tract symptoms: EpiLUTS

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.