Abstract
Purpose
To determine the prevalence of, and associated risk factors for, voiding and storage lower urinary tract symptoms (LUTS) in a population-based sample of Australian men.
Methods
Data were collected from 1,103 men randomly selected, community-dwelling men, as part of the Florey Adelaide Male Ageing Study, after exclusion of men with prostate or bladder cancer or prior surgery to either organ. The presence of LUTS was assessed using the International Prostate Symptom Score. Urine flow was measured via flow meter. Demographic, clinical, and bio-psychosocial data were collected by questionnaire.
Results
The prevalence of total, storage, and voiding LUTS was 18.1, 28.0 and 12.6%, respectively. The most common storage symptoms were frequency (12.3%), nocturia (9.9%) and urgency (8.1%), and voiding symptoms were weak stream (8.5%), intermittency (5.4%), incomplete emptying (5.1%) and straining (2.4%). There were linear associations between storage LUTS and increased abdominal fat mass, plasma glucose and low HDL cholesterol (components of the metabolic syndrome), obstructive sleep apnoea (OSA) risk, and retirement. Voiding symptoms were associated with a previous diagnosis of benign prostatic enlargement (BPH), mean peak urine flow, total energy intake, elevated risk of OSA, erectile dysfunction, physician-diagnosed thyroid dysfunction and higher household income.
Conclusions
The close association of storage LUTS with the metabolic syndrome, and of both storage and voiding LUTS with OSA, suggest that these conditions should be considered in men presenting with LUTS.
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References
Mongiu AK, McVary KT (2009) Lower urinary tract symptoms, benign prostatic hyperplasia, and obesity. Curr Urol Rep 10(4):247–253
Rohrmann S, Crespo CJ, Weber JR, Smit E, Giovannucci E, Platz EA (2005) Association of cigarette smoking, alcohol consumption and physical activity with lower urinary tract symptoms in older American men: findings from the third national health and nutrition examination survey. BJU Int 96(1):77–82
Orsini N, Rashidkhani B, Andersson SO, Karlberg L, Johansson JE, Wolk A (2006) Long-term physical activity and lower urinary tract symptoms in men. J Urol 176(6 Pt 1):2546–2550; discussion 2550
Rosen RC, Giuliano F, Carson CC (2005) Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Eur Urol 47(6):824–837
Parsons JK (2007) Modifiable risk factors for benign prostatic hyperplasia and lower urinary tract symptoms: new approaches to old problems. J Urol 178(2):395–401
Parsons JK, Bergstrom J, Silberstein J, Barrett-Connor E (2008) Prevalence and characteristics of lower urinary tract symptoms in men aged > or = 80 years. Urology 72(2):318–321
Roehrborn CG, Nuckolls JG, Wei JT, Steers W (2007) The benign prostatic hyperplasia registry and patient survey: study design, methods and patient baseline characteristics. BJU Int 100(4):813–819
Coyne KS, Sexton CC, Kopp ZS, Luks S, Gross A, Irwin D, Milsom I (2009) Rationale for the study methods and design of the epidemiology of lower urinary tract symptoms (EpiLuts) study. BJU Int 104(3):348–351
Martin S, Haren M, Taylor A, Middleton S, Wittert G (2007) Cohort profile: the Florey Adelaide male ageing study (FAMAS). Int J Epidemiol 36(2):302–306
Pinnock C, Marshall VR (1997) Troublesome lower urinary tract symptoms in the community: a prevalence study. Med J Aust 167(2):72–75
PROS (2003) Monitoring obesity in the south australian population which survey type (telephone, face-to-face or biomedical)? North West Adelaide Health Study- Brief Reports, vol 2
Litman HJ, Steers WD, Wei JT, Kupelian V, Link CL, McKinlay JB (2007) Relationship of lifestyle and clinical factors to lower urinary tract symptoms: results from Boston area community health survey. Urology 70(5):916–921
Li MK, Garcia LA, Rosen R (2005) Lower urinary tract symptoms and male sexual dysfunction in Asia: a survey of ageing men from five Asian countries. BJU Int 96(9):1339–1354
Russell S, McVary KT (2005) Lower urinary tract symptoms and erectile dysfunction: epidemiology and treatment in the aging man. Curr Urol Rep 6(6):445–453
Andersson SO, Rashidkhani B, Karlberg L, Wolk A, Johansson JE (2004) Prevalence of lower urinary tract symptoms in men aged 45–79 years: a population-based study of 40,000 Swedish men. BJU Int 94(3):327–331
Jones PP, Davy KP, Alexander S, Seals DR (1997) Age-related increase in muscle sympathetic nerve activity is associated with abdominal adiposity. Am J Physiol 272(6 Pt 1):E976–E980
Kupelian V, McVary KT, Barry MJ, Link CL, Rosen RC, Aiyer LP, Mollon P, McKinlay JB (2009) Association of C-reactive protein and lower urinary tract symptoms in men and women: results from Boston area community health survey. Urology 73(5):950–957
de Groat WC, Yoshimura N (2009) Afferent nerve regulation of bladder function in health and disease. Handb Exp Pharmacol 194:91–138
Kohler TS, McVary KT (2009) The relationship between erectile dysfunction and lower urinary tract symptoms and the role of phosphodiesterase type 5 inhibitors. Eur Urol 55(1):38–48
Klein JP, Waxman SG (2003) The brain in diabetes: molecular changes in neurons and their implications for end-organ damage. Lancet Neurol 2(9):548–554
Rohrmann S, Smit E, Giovannucci E, Platz EA (2004) Association between serum concentrations of micronutrients and lower urinary tract symptoms in older men in the third national health and nutrition examination survey. Urology 64(3):504–509
Kemmer H (2009) The relationship between sleep apnea and overactive bladder. Curr Urol Rep 10(6):448–450
Umlauf MG, Chasens ER, Greevy RA, Arnold J, Burgio KL, Pillion DJ (2004) Obstructive sleep apnea, nocturia and polyuria in older adults. Sleep 27(1):139–144
Margel D, Shochat T, Getzler O, Livne PM, Pillar G (2006) Continuous positive airway pressure reduces nocturia in patients with obstructive sleep apnea. Urology 67(5):974–977
Suzuki S, Platz EA, Kawachi I, Willett WC, Giovannucci E (2002) Intakes of energy and macronutrients and the risk of benign prostatic hyperplasia. Am J Clin Nutr 75(4):689–697
Haidinger G, Madersbacher S, Waldhoer T, Lunglmayr G, Vutuc C (1999) The prevalence of lower urinary tract symptoms in Austrian males and associations with sociodemographic variables. Eur J Epidemiol 15(8):717–722
Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, O’Leary MP, Puppo P, Robertson C, Giuliano F (2003) Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 44(6):637–649
Fliers E, Klieverik LP, Kalsbeek A (2010) Novel neural pathways for metabolic effects of thyroid hormone. Trends Endocrinol Metab 21(4):230–236
Ramberg H, Eide T, Krobert KA, Levy FO, Dizeyi N, Bjartell AS, Abrahamsson PA, Tasken KA (2008) Hormonal regulation of beta2-adrenergic receptor level in prostate cancer. Prostate 68(10):1133–1142
Lehrer S, Diamond EJ, Stone NN, Droller MJ, Stock RG (2002) Serum triiodothyronine is increased in men with prostate cancer and benign prostatic hyperplasia. J Urol 168(6):2431–2433
Acknowledgments
The authors would like to acknowledge the clinic and recruitment staff for their invaluable efforts. Particular thanks are extended to Janet Grant, Sandy Pickering and to staff of the North West Adelaide Health Study for all their assistance. Thanks to Chris Seaborn and Erika Bowden and staff at the Department of Nuclear Medicine, The Queen Elizabeth Hospital for providing expertise and assistance with DXA procedures. Finally, thanks are extended to our participants and their families for their invaluable contributions. The study was initially supported by The University of Adelaide’s Florey Foundation and is currently partially funded by the South Australian Government’s Men’s Health Program. Matthew T. Haren is supported by an NHMRC Training Fellowship (Public Health) (Grant #: 511345).
Conflict of interest
The authors declare that they have no conflict of interest.
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Martin, S.A., Haren, M.T., Marshall, V.R. et al. Prevalence and factors associated with uncomplicated storage and voiding lower urinary tract symptoms in community-dwelling Australian men. World J Urol 29, 179–184 (2011). https://doi.org/10.1007/s00345-010-0605-8
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DOI: https://doi.org/10.1007/s00345-010-0605-8