Treatment Status and Progression or Regression of Lower Urinary Tract Symptoms among Adults in a General Population Sample
Maserejian NN, Chen S, Chiu GR, Araujo AB, Kupelian V, Hall SA, McKinlay JB.J Urol. 2013 Jul 9. pii: S0022-5347(13)04861-1. doi: 10.1016/j.juro.2013.07.005. [Epub ahead of print]

Source

New England Research Institutes, 9 Galen St. Watertown, MA 02472, USA. Electronic address: nmaserejian@neriscience.com.

Abstract

PURPOSE:

To report progression and regression of lower urinary tract symptoms (LUTS) in a population-based cohort by race/ethnicity, sex, age and LUTS medication use.

MATERIALS AND METHODS:

The Boston Area Community Health Survey enrolled 5,502 participants aged 30-79 years of black, Hispanic, or white race/ethnicity. Five-year follow-up interviews were completed by 4,144 (1,610 men, 2,534 women; conditional response rate of 80%). Population-weighted estimates of LUTS severity were assessed using American Urological Association Symptom Index (AUASI) and analyzed using multivariable models.

RESULTS:

Symptom progression (AUASI increase ≥3) was reported by 21-33% of participants, and regression (decrease ≥3) by 30-44% of participants, most commonly women and Hispanics. Age and higher body mass index (BMI) were associated with progression (P<0.01), but not regression. LUTS medication use at baseline only was associated with improved symptoms scores five years later (multivariable-adjusted OR=3.10, 95% CI 1.28-7.51, compared to non-users), whereas using medication at both baseline and follow-up was associated with similar rates of progression and regression as observed among participants not using LUTS medication at either time point.

CONCLUSIONS:

LUTS persisted at follow-up for approximately half of the population experiencing symptoms at baseline, including many men and women using LUTS medications. Overall, however, LUTS medication use and surgical treatment appeared beneficial for symptom control at 5-year follow-up. Age and BMI were associated with symptom worsening, and Hispanic ethnicity was associated with greater symptom fluctuation. Clinicians should consider the higher likelihood of LUTS progression for older or heavier patients, and monitor responsiveness to LUTS medication.