PURPOSE: To determine the metabolic, lifestyle and physical factors associated with progression or improvement of storage and voiding lower urinary tract symptoms (LUTS) in a population-based cohort of men.
METHODS: After exclusion of men with prostate or bladder cancer and/or surgery, progression and improvement of storage and voiding LUTS was assessed using the AUA-SI in 780 men, aged 35-80 years at baseline who attended five-year follow-up clinics.
RESULTS: Storage and voiding LUTS progressed in 39.8% (n=308) and 32.3% (n=250) of men respectively, and improved in 33.1% (n=256) and 23.4% (n=181) respectively. In final adjusted regression models, higher bother and physical activity at baseline predicted improvement of both storage and voiding LUTS, while higher income, HDL cholesterol, and lower triglycerides predicted improvement of storage LUTS only. Being widowed, higher plasma estradiol, and depression at baseline predicted progression of both storage and voiding LUTS, while higher abdominal fat mass and obstructive sleep apnea (OSA) risk predicted storage LUTS progression only. Higher age, lower HDL cholesterol, testosterone, and income, previous BPH and erectile dysfunction at baseline predicted the progression of voiding LUTS only. The initiation or continued use of either α-blockers or anti-cholinergics (storage LUTS), and 5-α reductase inhibitors (voiding LUTS) were associated with symptom improvement.
CONCLUSIONS: LUTS may progress or remit. Even accounting for medication use, progression may be associated with modifiable disease, metabolic, or behavioural factors, which are also risk factors for type 2 diabetes and cardiovascular disease. These should be looked for and managed.
Written by:
Martin S, Lange K, Haren MT, Taylor AW, Wittert G. Are you the author?
Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, South Australia; School of Medicine, University of Adelaide, Adelaide, South Australia.
Reference: J Urol. 2013 Jun 11. pii: S0022-5347(13)04604-1.
doi: 10.1016/j.juro.2013.06.018
PubMed Abstract
PMID: 23770136
