Presentation Authors: Nnenaya Q. Agochukwu*, Jonathan B. Wiseman, Abigail R. Smith, Margaret E. Helmuth, Ann Arbor, MI, Kevin P. Weinfurt, Durham, NC, 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, Meera Tavathia, Chicago, IL, J. Quentin Clemens, and the LURN Study Group, Ann Arbor, MI
Introduction: The degree of bother attributed to lower urinary tract symptoms (LUTS) drives care seeking and treatment aggressiveness. The longitudinal correlation of symptom severity and bother, however, is not well understood. In this study, we conducted a longitudinal evaluation of the correlation between symptom severity and bother in men and women seeking care for LUTS.
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 questionnaire, which includes 22 questions that evaluate an individual&[prime]s LUTS symptom severity and bother. Polychoric correlations between symptom severity and bother were calculated for all 22 symptoms at baseline, 3 and 12 months. Repeated measures linear regression models were used to assess differences in correlations between males and females, and over time.
Results: 519 men and 545 women reported on their symptoms at any of the three time points. There were no racial or ethnic differences between men and women (p-value=0.620 and 0.907, respectively). Men were older than women (61.2 vs 56.4, p-value < 0.001). The LUTS symptoms associated with highest correlations between severity and bother (â‰¥0.80 for at least two time points) were incomplete emptying, urgency, urgency with fear of leakage and bladder pain. Those with lowest correlations (â‰¤0.65 for at least two time points) were daytime frequency, nocturia, splitting or spraying, urinary incontinence (UI) while sleeping and UI for no reason [Figure 1]. Correlations between severity and bother in men and women were largely similar, with the exception of higher correlations for frequency, nocturia, incomplete emptying, hesitancy and straining symptoms in women and higher correlation for UI during sex in men. Correlations between severity and bother for UI and urgency incontinence symptoms increased over time, while correlations for straining symptoms decreased over time.
Conclusions: The relationship between LUTS severity and bother is complex, and effective treatments should improve both. Individual LUTS severity and bother values correlate highly but not perfectly. In most situations (including clinical care), measurement of both is likely redundant.
Source of Funding: Funding provided by grants from NIH/NIDDK