Presentation Authors: Nnenaya Q. Agochukwu*, Jonathan B. Wiseman, Abigail R. Smith, Margaret E. Helmuth, Ann Arbor, MI, Kevin P. Weinfurt, Durham, NC, Meera Tavathia, Chicago, IL, Aruna V. Sarma, Ann Arbor, MI, James W. Griffith, David Cella, Chicago, IL, Anne P. Cameron, Ann Arbor, MI, Kathryn E. Flynn, Milwaukee, WI, Bradley A. Erickson, Iowa City, IA, Ziya Kirkali, Bethesda, MD, Cindy L. Amundsen, Durham, NC, H. Henry Lai, St. Louis, MO, J. Quentin Clemens, and the LURN Study Group, Ann Arbor, MI
Introduction: The degree of bother caused by LUTS often guides treatment decisions. However, the relationship of LUTS severity and bother at the individual level and for individual symptoms is poorly understood. Aggregate measures are useful for evaluation of trends, but do not characterize individual variation. In this study, we evaluated individual variation of symptom severity and bother and characteristics of individuals with high LUTS bother.
Methods: Men and women with LUTS seeking care at 6 tertiary care centers were enrolled in The Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) Observational Cohort Study. Participants completed the LUTS Tool, which includes 22 LUTS severity and bother questions. Baseline LUTS tool responses were analyzed. Items were categorized into 6 groups based on symptom. Severity and bother components were separately summed within each group and normalized to range from 0 to 1. The discordance score (range -1 to 1) was calculated as the difference between the normalized severity and bother. Scores closer to 1 and -1 represent discordant symptoms where bother severity, respectively, while scores close to 0 represent concordance between severity and bother. Patients were grouped into &[Prime]high bother discordance&[Prime], &[Prime]low bother discordance&[Prime], and &[Prime]no discordance&[Prime] groups. Multivariable logistic regression was used to identify characteristics associated with group membership in the high bother discordant group.
Results: Data were available for 1064 participants (519 men and 545 women). Across question groups, 6-27% of the cohort were in the high bother discordant group, 3-26% were in the low bother discordant group, and 68-87% were in the no discordant group (Figure 1). In multivariable regression, female patients, black patients, increases in self-reported genitourinary pain, and depression scores were associated with higher odds of having a &[Prime]high bother discordance&[Prime].
Conclusions: For all LUTS categories, there is variation amongst individuals in the degree of bother associated with severity of a given symptom. Identification of individuals with LUTS bother discordance may allow for the identification of associated phenotypes, which may be useful in determining those that may require an individualized treatment plan to address their LUTS.
Source of Funding: Funding provided by grants from NIH/NIDDK