Gender differences of lower urinary tract symptoms in older Chinese Americans

Objective: To describe whether or not there are gender differences in lower urinary tract symptoms (LUTS) prevalence and risk factors in community-dwelling older Chinese Americans. Methods: We performed a secondary analysis of a prospective cross-sectional population-based survey of Chinese Americans aged 60 years and older between January 2011 and December 2013 in English, Mandarin, Cantonese, Taishanese, or Teochew. A clinical review of systems was used to assess LUTS, which included urinary frequency, urgency, burning and/or pain, blood in urine, and urinary incontinence. Results: Of the total 3157 people queried, 42% were men and 58% were women. More men reported LUTS compared to women (32.9% vs. 28.6%, p=0.01). In a multivariable analysis, female gender (adjusted odds ratio [aOR] 0.60, 95% confidence interval [CI] 0.49–0.73), being married (aOR 0.79, 95% CI 0.65–0.97), and smoking (aOR 0.66, 95% CI 0.49–0.88) were found to be protective, while traditional Chinese medicine use (aOR 1.51, 95% CI 1.28–1.78), heart disease (aOR 1.54, 95% CI 1.24–1.91), and anxiety (aOR 1.69, 95% CI 1.25–2.28) were most strongly associated with increased odds of LUTS. When examining genders separately, being married was found to be protective only in women. Meanwhile, unique factors found in men were hypertension, heart disease, and practice of Tai Chi. Conclusion: In this large population-based study, LUTS were more prevalent in older Chinese American men than women. We also found gender-specific factors that influenced the odds of reporting LUTS; however, traditional Chinese medicine use was the only factor that was shared by both genders. Future longitudinal investigations are needed to elucidate these underlying mechanisms to provide evidence-based and culture-specific guidelines for this rapidly growing population.