Patient characteristics associated with more bother from lower urinary tract symptoms

Alice B. Liu, Qian Liu, Claire C. Yang, James W. Griffith, Abigail R. Smith, Margaret E. Helmuth, H. Henry Lai, Cindy L. Amundsen, Bradley A. Erickson, J. Eric Jelovsek, Nnenaya Q. Agochukwu, Margaret G. Mueller, Victor P. Andreev, Kevin P. Weinfurt, Kimberly S. Kenton, Matthew O. Fraser, Anne P. Cameron, Ziya Kirkali, John L. Gore

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Purpose: Some patients continue to have bothersome lower urinary tract symptoms despite treatment. We examined characteristics associated with bother from lower urinary tract symptoms in a prospective cohort. Materials and Methods: In this 1-year prospective, observational cohort study we obtained data on patients with lower urinary tract symptoms who were seeking care at a total of 6 tertiary care centers in the United States. Participants answered the AUA-SI (American Urological Association Symptom Index) global urinary bother question at study entry and 1,2 months later. Multilevel logistic and linear regression was used to identify factors associated with worsening bother and bother at 1,2 months, respectively. Results: Of the 756 participants 1,21 (16%) had worsened lower urinary tract symptom bother during the study period. When adjusted for other variables, worsened lower urinary tract symptom bother was more likely among men who were nonwhite (OR 1.79, 95% CI 0.94e3.40) or who had diabetes (OR 1.68, 95% CI 0.86e3.27) and among women with diabetes (OR 1.77, 95% CI 0.85e3.67), prior treatment of lower urinary tract symptoms (OR 2.58, 95% CI 1.22e5.46) or a higher depression level (OR 1.29, 95% CI 1.10e1.52). Baseline factors associated with more severe bother at 1,2 months in men included more severe bother at baseline, nonwhite race, worse urinary frequency and incontinence, and, higher levels of stress (p <0.05). Among women more severe bother at baseline, urinary urgency and frequency, and worse physical function were associated with more severe bother at 1,2 months. Conclusions: Urinary symptom severity at baseline, race, depression and psychological stress were associated with the bother of lower urinary tract symptoms in a prospective cohort of men and women treated at tertiary care facilities. These findings may inform the clinical care of patients with bothersome lower urinary tract symptoms and direct providers to better prognosticate for patients with challenging lower urinary tract symptoms cases.

Original languageEnglish
Pages (from-to)585-591
Number of pages7
JournalJournal of Urology
Volume202
Issue number3
DOIs
StatePublished - Sep 2019

Keywords

  • Lower urinary tract symptoms
  • Patient reported outcome measures
  • Population characteristics
  • Prognosis
  • Urinary bladder

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    Liu, A. B., Liu, Q., Yang, C. C., Griffith, J. W., Smith, A. R., Helmuth, M. E., Lai, H. H., Amundsen, C. L., Erickson, B. A., Jelovsek, J. E., Agochukwu, N. Q., Mueller, M. G., Andreev, V. P., Weinfurt, K. P., Kenton, K. S., Fraser, M. O., Cameron, A. P., Kirkali, Z., & Gore, J. L. (2019). Patient characteristics associated with more bother from lower urinary tract symptoms. Journal of Urology, 202(3), 585-591. https://doi.org/10.1097/JU.0000000000000324