Impact of urinary symptoms on bothersomeness and quality of life in young men

Comparative study of international prostate symptom scores and urodynamic parameters in men and women with lower urinary tract symptoms

BACKGROUND

We compared urinary symptoms and urodynamic parameters in men and women with lower urinary tract symptoms.

METHODS

A total of 164 individuals (76 men and 88 women) were rated according to the International Prostate Symptom Score and underwent a detailed urodynamic investigation. Patients were stratified by age into 2 groups, namely, those < 50 years (the younger group) and those > 50 years (the elderly group).

RESULTS

In the elderly group, scores of voiding symptoms for men were higher than those for women (p = 0.012). Maximum flow rates (Qmax) for women were higher than those for men (p = 0.025 for the younger groups, and p < 0.001 for the elderly groups). Detrusor pressure at Qmax (p < 0.001), opening pressure (p < 0.001) and closing pressure (p = 0.023) were elevated in elderly men vs. in elderly women. A multiple linear regression analysis identified straining (beta = 0.479, p < 0.05) and incomplete emptying (beta = 0.487, p < 0.05) as the only variables influencing quality of life (QOL) in younger men and women, respectively. In elderly men, nocturia (beta = 0.352, p < 0.05) and frequency (beta = 0.287, p < 0.05) were significantly associated with QOL. Frequency (beta = 0.452, p < 0.05) possibly explained a QOL reduction in elderly women.

CONCLUSIONS

Our findings suggest that in the elderly patients, storage symptoms are more associated with QOL than voiding symptoms. However, storage symptoms were not associated with QOL in younger men.

Influence of pain and urinary symptoms on quality of life in young men with chronic prostatitis-like symptoms

BACKGROUND

Our aims in the present study were to estimate the influences of pain and urinary symptoms on quality of life, and to determine which of these two variables has the most predictive power with respect to quality of life in young men with chronic prostatitis-like symptoms.

METHODS

Chronic prostatitis-like symptoms were measured by the National Institutes of Health-Chronic Prostatitis Symptom Index. Of the 28,841 men aged 20 years who lived in the study community, 18,495 men (a response rate 64.1%) agreed to participate in the study. A total of 1057 men who complained of symptoms indicative of chronic prostatitis were included in the study. The influences of pain and urinary symptoms on quality of life were determined using logistic regression analysis. The receiver operating characteristic (ROC) curve was used to estimate the predictive ability of each of these variables with respect to quality of life.

RESULTS

Results from multivariate analysis showed that both pain and urinary symptoms were associated with an increased likelihood of impaired quality of life, although pain contributed more to a reduced quality of life than urinary symptoms. Relative to men who experienced mild pain, men who experienced moderate pain had a 3.9-fold risk of poor quality of life (odds ratio [OR], 3.87; 95% confidence interval [CI], 2.86-5.23; P < 0.001) and those who experienced severe pain had a 15.7-fold risk of reduced quality of life (OR, 15.68; 95% CI, 6.59-37.35; P < 0.001). Moderate urinary symptoms were associated with a 1.4-fold risk of bother (OR, 1.41; 95% CI, 1.01-1.99; P < 0.001) and severe urinary symptoms were associated with 2.4-fold risk (OR, 2.39; 95% CI, 1.37-4.12; P < 0.001), relative to mild urinary symptoms. Comparison of the effects of pain and urinary symptoms showed that pain severity had the most predictive power for bother, quality of life, and quality-of-life impact. The areas under the ROC curves for bother, quality of life, and quality-of-life impact were 71.3%, 69.3% and 72.5%, respectively.

CONCLUSION

Urinary symptoms and pain might be associated with an increased likelihood of impaired quality of life in young men with chronic prostatitis-like symptoms. In addition, our findings suggest that pain severity is the most influential variable for determining quality of life in this population.