Association of Bowel Habits with Lower Urinary Tract Symptoms in Adult Men: Findings from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Survey (NHANES)
Thurmon KL, Breyer BN, Erickson BA. J Urol. 2012 Oct 10. pii: S0022-5347(12)05187-7. doi: 10.1016/j.juro.2012.10.008. [Epub ahead of print]


University of Iowa Department of Urology. Electronic address:



To examine the association between self-reported lower urinary tract symptoms (LUTS) and bowel habits in men in a large cross-sectional population-based cohort study.


The study included 3077 men participating in the 2005-2006 or 2007-2008 cycles of the National Health and Nutrition Examination Survey (NHANES), who were ≥ 40 years old and without a history of prostate cancer. Men were considered to have LUTS if they reported nocturia, urinary hesitancy and/or incomplete bladder emptying. Bowel habits were characterized by frequency of bowel movements per week and stool consistency based on the Bristol Stool Form Scale. Weighted associations between bowel habits and LUTS were determined using both univariate and multivariable techniques, adjusting for age, race, BMI, diabetes, alcohol intake, activity level and smoking.


The prevalence of LUTS was 37%, with 4% reporting all three symptoms. Reporting ≤3 BMs/week was associated with nocturia (OR 1.67, 95% CI 1.21-2.30), incomplete bladder emptying (OR 2.14, 95% CI 1.06-4.31), and urinary hesitancy (OR 2.06, 95% CI 1.06-4.02). Reporting >10 BMs/week was associated with nocturia only (OR 1.42, 95% CI 1.01-1.55). Both hard (OR 1.76; 95% CI 1.31-2.37) and loose (OR 1.25; 95% CI 1.01-1.55) stool consistency increased the odds of reporting nocturia.


LUTS in the adult male were independently associated with low stool frequency, hard stool type, and loose stool type. These data suggest either causality or a common pathophysiology of LUTS and abnormalities of bowel habits.