Impact of Sleep Disturbance, Physical Function, Depression and Anxiety on Male Lower Urinary Tract Symptoms: Results from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)

Alexander P. Glaser*, Sarah Mansfield, Abigail R. Smith, Brian T. Helfand, H. Henry Lai, Aruna Sarma, Claire C. Yang, Michelle Taddeo, J. Quentin Clemens, Anne P. Cameron, Kathryn E. Flynn, Victor Andreev, Matthew O. Fraser, Bradley A. Erickson, Ziya Kirkali, James W. Griffith

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Purpose:The impact of nonurological factors on male lower urinary tract symptoms (LUTS) remains unclear. We investigated cross-sectional and longitudinal associations among anxiety, depression, physical function, sleep quality and urinary symptom subdomains.Materials and Methods:Data from 518 men in the LURN (Symptoms of Lower Urinary Tract Dysfunction Research Network) study were analyzed to identify associations between Patient-Reported Outcomes Measurement Information System® (PROMIS®) depression, anxiety, sleep disturbance and physical function measures and LUTS subdomains, as derived from the American Urological Association Symptom Index and LUTS Tool. Multivariable linear regression was used to assess the relationships between PROMIS measures and LUTS subdomains at baseline and at 3- and 12-month followup.Results:Baseline depression and anxiety were associated with urinary incontinence (p <0.001), voiding symptoms (p <0.001) and quality of life (p=0.002), whereas baseline sleep disturbance was associated with voiding and storage symptoms and quality of life (p <0.001 for all). Urinary symptom severity improved in all subdomains at 3 and 12 months. Similar associations between PROMIS measures and LUTS subdomains were observed at all time points, but baseline depression, anxiety, sleep disturbance and physical function measures were not associated with longitudinal trajectories of LUTS.Conclusions:Urinary symptom subdomains are independently associated with modifiable clinical variables including sleep quality and depression at all time points, but these variables do not predict the degree of improvement in LUTS following urological evaluation and treatment over the medium term. Bidirectional assessment and randomized experiments may improve our understanding of these relationships.

Original languageEnglish (US)
Pages (from-to)155-163
Number of pages9
JournalJournal of Urology
Volume208
Issue number1
DOIs
StatePublished - Jul 1 2022

Funding

Support: National Institute of Diabetes and Digestive and Kidney Diseases (Grants DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK099879). Research reported in this publication was supported at Northwestern University, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences (Grant UL1TR001422). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Keywords

  • anxiety
  • depression
  • lower urinary tract symptoms
  • patient reported outcome measures
  • quality of life

ASJC Scopus subject areas

  • Urology

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