The impact of non-urologic factors on male lower urinary tract symptoms (LUTS) remains unclear. We investigated cross-sectional and longitudinal associations among anxiety, depression, physical function, sleep quality and urinary symptom sub-domains.
Data from 518 men in the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) study were analyzed to identify associations between PROMIS depression, anxiety, sleep disturbance, and physical function measures and LUTS sub-domains, as derived from the AUA-Symptom Index and LUTS Tool. Multivariable linear regression was used to assess the relationships between PROMIS measures and LUTS sub-domains at baseline and at 3- and 12-month follow-up.
Baseline depression and anxiety were associated with urinary incontinence (UI; p<0.001), voiding symptoms (p<0.001), and quality of life (QOL, p=0.002), whereas baseline sleep disturbance was associated with voiding and storage symptoms and QOL (p<0.001 for all). Urinary symptom severity improved in all sub-domains at 3 and 12 months. Similar associations between PROMIS measures and LUTS sub-domains were observed at all time points, but baseline depression, anxiety, sleep disturbance, and physical function measures were not associated with longitudinal trajectories of LUTS.
Urinary symptom sub-domains are independently associated with modifiable clinical variables including sleep quality and depression at all time points, but these variables do not predict the degree of improvement in LUTS following urologic evaluation and treatment over the medium-term. Bidirectional assessment and randomized experiments may improve our understanding of these relationships.
The Journal of urology. 2022 Feb 25 [Epub ahead of print]
Alexander P Glaser, Sarah Mansfield, Abigail R Smith, Brian T Helfand, H Henry Lai, Aruna Sarma, Claire C Yang, Michelle Taddeo, J Quentin Clemens, Anne P Cameron, Kathryn E Flynn, Victor Andreev, Matthew O Fraser, Bradley A Erickson, Ziya Kirkali, James W Griffith
NorthShore Medical Group, Glenview, Illinois., Arbor Research Collaborative for Health, Ann Arbor, Michigan., NorthShore University Health System, Evanston, Illinois., Division of Urologic Surgery, Departments of Surgery and Anesthesiology, Washington University School of Medicine, St Louis, Missouri., Department of Urology, University of Michigan Health System, Ann Arbor, Michigan., Department of Urology, University of Washington, Seattle, Washington., Northwestern University - The Feinberg School of Medicine, Chicago, Illinois., University of Michigan, Ann Arbor, Michigan., Medical College of Wisconsin, Milwaukee, Wisconsin., Duke University, Durham, North Carolina., University of Iowa Carver College of Medicine, Iowa City, Iowa., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryl.