Urinary urgency is the most bothersome lower urinary tract symptom (LUTS) at the population level, whereas urgency incontinence causes the most bother to individuals, a large European survey reveals.
In this population-based cross-sectional study, researchers mailed the Danish Prostatic Symptom Score questionnaire to 6000 randomly selected adults aged 18–79 years across Finland.
A total of 3597 people returned the questionnaire, which asked respondents about the frequency and bother associated with 12 LUTS.
From a population perspective and after adjusting for age, the most prevalent symptom that was rated as at least moderately bothersome was urgency (7.9%), followed by stress urinary incontinence (6.5%), nocturia (6.0%), postmicturition dribble (5.8%) and urgency urinary incontinence (5.0%).
The prevalence of bothersome stress urinary incontinence was much higher in women than in men (12.0 vs 0.8%) as was the overall burden of urgency urinary incontinence and other incontinence.
Conversely, the prevalence of bothersome voiding symptoms (hesitancy, weak stream and straining) and postmicturition dribble were all more common in men than in women.
From the perspective of individual respondents, urgency urinary incontinence was the most prevalent bothersome symptom, affecting 30.7% of all symptomatic individuals.
All other symptoms were rated as causing little or no bother in the majority of symptomatic individuals, and with no major differences between men and women or between age groups.
Writing in European Urology, the researchers note that there were large differences between individual-level and population-level perspectives on symptom bother. They also remark that “no bother” and “minor bother” were the most common responses for each of the 12 symptoms listed in the questionnaire.
Also, differences between genders were apparent at the population level whereas, among symptomatic individuals, the distribution of bother was similar in men and women.
“These findings suggest strongly that although the etiology of LUTS may be different between genders, the bother impact on individuals is similar,” write Kari Tikkinen (McMaster University, Hamilton, Ontario, Canada) and colleagues.
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