Lower urinary tract symptoms and related help-seeking behavior in South Asian men living in the UK

South Asian men have more urinary problems than white men, but are only half as likely to seek help, according to a study of just under 8,000 men published in the September issue of the urology journal BJU International.

Men over 40 living in Leicestershire, UK, were selected at random from the lists of family doctors and sent a postal questionnaire asking them about urinary symptoms, problems and use of local health services.

7,810 men completed the questionnaire – an overall response rate of 64 per cent. Although the response rate from South Asian men was lower – at 39 per cent - comparisons with the 2001 census showed that the respondents were representative of the age, socio-economic status and health profile of the area.

More than a third of the 409 South Asian men who replied (37 per cent), described at least one significant urinary problem, compared with 29 per cent of the white men in the study.

Around a third of the men in each ethnic group told researchers that they felt that they needed help with their urinary problem.

Yet only a quarter of the South Asian men (25 per cent) who fell into this category had actually sought help for their problems, compared with more than half of the white men (53 per cent).

The differences were most pronounced when it came to problems storing urine in the bladder. South Asian men were approximately two to three times more likely to suffer from issues like urinating frequently, needing to go urgently, suffering from incontinence and having to get up to urinate at night.

"Lower urinary tract symptoms are common in middle-aged men and tend to increase with age" explains Mr Joby Taylor, Specialist Registrar in Urology, who carried out the research while working at Mid-Yorkshire Hospitals NHS Trust. The Trust teamed up with the University of Leicester and Leicestershire MRC Incontinence Study Team to undertake the study.

"Population studies have shown that a quarter of men over 40 have moderate or severe symptoms and this rises to half at the age of 65" he adds.

"Many of these men will find their symptoms bothersome and they can have a significant impact on their quality of life. This seems to be particularly true for South Asian men."

South Asian men form the largest minority ethnic group in the UK and the authors argue that further work is needed to break down the barriers that prevent them from seeking help when they have urinary problems.

"The low levels of help-seeking behaviour seen in this study suggest that interventions focused on primary or secondary health care are unlikely to improve treatment rates" adds Mr Taylor.

"Cultural issues are an important factor in seeking help for medical problems and may influence the behaviour of South Asian men affected by urinary problems.

"Focused care strategies involving Asian link workers and enhanced community services have shown benefits in treating other chronic diseases in the South Asian population. A similar approach might be needed to address the ongoing and unmet need or urinary problems."