A population-based survey looking at the prevalence of lower urinary tract symptoms in Korean men aged 40 years or older, "Beyond the Abstract," by Tae Heon Kim, MD

BERKELEY, CA (UroToday.com) - Lower urinary tract symptoms (LUTS) are a common problem of aging men. Despite efforts by the International Continence Society (ICS) to standardize the terminology and definitions for LUTS,[1] many investigators use different definitions or criteria to survey participants in epidemiological studies and to enroll patients in clinical trials. Few prevalence studies have used the 2002 ICS symptom definitions for LUTS, especially in Asia. Therefore, we investigated the prevalence of LUTS using the 2002 ICS definitions in Korean men aged ≥ 40.

We conducted a door-to-door, cross-sectional study using a questionnaire that was originally developed for the previous EPIC study.[2] The questionnaire used to evaluate LUTS in this study included symptoms of storage, voiding, and post-micturition, usually during the past month. The response options for most LUTS were measured on a 2-point scale (“yes” or no”) or a 6-point scale (i.e., “not at all,” “less than 1 time in 5,” “less than half the time,” “about half the time,” “more than half the time,” and “almost always”). The 2002 ICS defined nocturia as waking to void one or more times per night. For comparison, we established the second definition of nocturia as two or more nocturnal micturitions per night. Participants were recruited from five Korean provinces (Seoul, Busan, Daegu, Daejeon, and Gwangju). A random sample was acquired through the Post and Address Registry of Korea using a two-stage sampling method. All data were collected via individual face-to-face interviews, usually in the respondent’s home.

The results of this survey showed that 83.4% of respondents (1 536/1 842) reported having at least one LUT (storage, voiding, or post-micturition symptom). Combined storage and voiding symptoms were the most frequently reported combination with 48.0%, and 30.2% reporting experiencing all three symptoms. Nocturia (65.0%) was the most common storage symptom among respondents. When the definition of nocturia was changed to reflect two or more nocturnal micturitions per night, the prevalence of nocturia decreased to 20.4%.There was an increase in prevalence of LUTS with age: 78.3% in respondents aged 40 - 49, 84.7% in those aged 50 - 59, and 89.6% in 60 years or more. The severity of LUTS assessed by the International Prostate Symptom Score also increased with advancing age. A particular weakness of our study was low response rate (26.8%). Nonresponse bias would be an issue if the subjects responding to our survey were consistently different from those who did not respond. Nonetheless, our study has important implications for clinical practice and emphasizes the need for comprehensive assessments in men with LUTS. In particular, these data enrich the literature on LUTS in elderly men.

References:

  1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002;21:167-78.
  2. Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 2006;50:1306-14.

Written by:
Tae Heon Kim, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

The prevalence of lower urinary tract symptoms in Korean men aged 40 years or older: A population-based survey - Abstract

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