Patient Characteristics Associated with More Bother from Lower Urinary Tract Symptoms

LURN Study Group

Research output: Contribution to journalArticle

Abstract

PURPOSE: Some patients continue to have bothersome lower urinary tract symptoms despite treatment. We examined characteristics associated with bother from lower urinary tract symptoms in a prospective cohort. MATERIALS AND METHODS: In this 1-year prospective, observational cohort study we obtained data on patients with lower urinary tract symptoms who were seeking care at a total of 6 tertiary care centers in the United States. Participants answered the AUA-SI (American Urological Association Symptom Index) global urinary bother question at study entry and 12 months later. Multilevel logistic and linear regression was used to identify factors associated with worsening bother and bother at 12 months, respectively. RESULTS: Of the 756 participants 121 (16%) had worsened lower urinary tract symptom bother during the study period. When adjusted for other variables, worsened lower urinary tract symptom bother was more likely among men who were nonwhite (OR 1.79, 95% CI 0.94-3.40) or who had diabetes (OR 1.68, 95% CI 0.86-3.27) and among women with diabetes (OR 1.77, 95% CI 0.85-3.67), prior treatment of lower urinary tract symptoms (OR 2.58, 95% CI 1.22-5.46) or a higher depression level (OR 1.29, 95% CI 1.10-1.52). Baseline factors associated with more severe bother at 12 months in men included more severe bother at baseline, nonwhite race, worse urinary frequency and incontinence, and higher levels of stress (p <0.05). Among women more severe bother at baseline, urinary urgency and frequency, and worse physical function were associated with more severe bother at 12 months. CONCLUSIONS: Urinary symptom severity at baseline, race, depression and psychological stress were associated with the bother of lower urinary tract symptoms in a prospective cohort of men and women treated at tertiary care facilities. These findings may inform the clinical care of patients with bothersome lower urinary tract symptoms and direct providers to better prognosticate for patients with challenging lower urinary tract symptoms cases.

Original languageEnglish (US)
Pages (from-to)585-591
Number of pages7
JournalThe Journal of urology
Volume202
Issue number3
DOIs
StatePublished - Sep 1 2019

Fingerprint

Lower Urinary Tract Symptoms
Depression
Urinary Incontinence
Tertiary Healthcare
Psychological Stress
Tertiary Care Centers
Observational Studies
Linear Models
Patient Care
Cohort Studies
Logistic Models

Keywords

  • lower urinary tract symptoms
  • patient reported outcome measures
  • population characteristics
  • prognosis
  • urinary bladder

ASJC Scopus subject areas

  • Urology

Cite this

@article{63042047927041a8b626cc75624fe2d8,
title = "Patient Characteristics Associated with More Bother from Lower Urinary Tract Symptoms",
abstract = "PURPOSE: Some patients continue to have bothersome lower urinary tract symptoms despite treatment. We examined characteristics associated with bother from lower urinary tract symptoms in a prospective cohort. MATERIALS AND METHODS: In this 1-year prospective, observational cohort study we obtained data on patients with lower urinary tract symptoms who were seeking care at a total of 6 tertiary care centers in the United States. Participants answered the AUA-SI (American Urological Association Symptom Index) global urinary bother question at study entry and 12 months later. Multilevel logistic and linear regression was used to identify factors associated with worsening bother and bother at 12 months, respectively. RESULTS: Of the 756 participants 121 (16{\%}) had worsened lower urinary tract symptom bother during the study period. When adjusted for other variables, worsened lower urinary tract symptom bother was more likely among men who were nonwhite (OR 1.79, 95{\%} CI 0.94-3.40) or who had diabetes (OR 1.68, 95{\%} CI 0.86-3.27) and among women with diabetes (OR 1.77, 95{\%} CI 0.85-3.67), prior treatment of lower urinary tract symptoms (OR 2.58, 95{\%} CI 1.22-5.46) or a higher depression level (OR 1.29, 95{\%} CI 1.10-1.52). Baseline factors associated with more severe bother at 12 months in men included more severe bother at baseline, nonwhite race, worse urinary frequency and incontinence, and higher levels of stress (p <0.05). Among women more severe bother at baseline, urinary urgency and frequency, and worse physical function were associated with more severe bother at 12 months. CONCLUSIONS: Urinary symptom severity at baseline, race, depression and psychological stress were associated with the bother of lower urinary tract symptoms in a prospective cohort of men and women treated at tertiary care facilities. These findings may inform the clinical care of patients with bothersome lower urinary tract symptoms and direct providers to better prognosticate for patients with challenging lower urinary tract symptoms cases.",
keywords = "lower urinary tract symptoms, patient reported outcome measures, population characteristics, prognosis, urinary bladder",
author = "{LURN Study Group} and Liu, {Alice B.} and Qian Liu and Yang, {Claire C.} and Griffith, {James W.} and Smith, {Abigail R.} and Helmuth, {Margaret E.} and Lai, {H. Henry} and Amundsen, {Cindy L.} and Erickson, {Bradley A.} and Jelovsek, {J. Eric} and Agochukwu, {Nnenaya Q.} and Mueller, {Margaret G.} and Andreev, {Victor P.} and Weinfurt, {Kevin P.} and Kenton, {Kimberly S.} and Fraser, {Matthew O.} and Cameron, {Anne P.} and Ziya Kirkali and Gore, {John L.}",
year = "2019",
month = "9",
day = "1",
doi = "10.1097/JU.0000000000000324",
language = "English (US)",
volume = "202",
pages = "585--591",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "3",

}

Patient Characteristics Associated with More Bother from Lower Urinary Tract Symptoms. / LURN Study Group.

In: The Journal of urology, Vol. 202, No. 3, 01.09.2019, p. 585-591.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Patient Characteristics Associated with More Bother from Lower Urinary Tract Symptoms

AU - LURN Study Group

AU - Liu, Alice B.

AU - Liu, Qian

AU - Yang, Claire C.

AU - Griffith, James W.

AU - Smith, Abigail R.

AU - Helmuth, Margaret E.

AU - Lai, H. Henry

AU - Amundsen, Cindy L.

AU - Erickson, Bradley A.

AU - Jelovsek, J. Eric

AU - Agochukwu, Nnenaya Q.

AU - Mueller, Margaret G.

AU - Andreev, Victor P.

AU - Weinfurt, Kevin P.

AU - Kenton, Kimberly S.

AU - Fraser, Matthew O.

AU - Cameron, Anne P.

AU - Kirkali, Ziya

AU - Gore, John L.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - PURPOSE: Some patients continue to have bothersome lower urinary tract symptoms despite treatment. We examined characteristics associated with bother from lower urinary tract symptoms in a prospective cohort. MATERIALS AND METHODS: In this 1-year prospective, observational cohort study we obtained data on patients with lower urinary tract symptoms who were seeking care at a total of 6 tertiary care centers in the United States. Participants answered the AUA-SI (American Urological Association Symptom Index) global urinary bother question at study entry and 12 months later. Multilevel logistic and linear regression was used to identify factors associated with worsening bother and bother at 12 months, respectively. RESULTS: Of the 756 participants 121 (16%) had worsened lower urinary tract symptom bother during the study period. When adjusted for other variables, worsened lower urinary tract symptom bother was more likely among men who were nonwhite (OR 1.79, 95% CI 0.94-3.40) or who had diabetes (OR 1.68, 95% CI 0.86-3.27) and among women with diabetes (OR 1.77, 95% CI 0.85-3.67), prior treatment of lower urinary tract symptoms (OR 2.58, 95% CI 1.22-5.46) or a higher depression level (OR 1.29, 95% CI 1.10-1.52). Baseline factors associated with more severe bother at 12 months in men included more severe bother at baseline, nonwhite race, worse urinary frequency and incontinence, and higher levels of stress (p <0.05). Among women more severe bother at baseline, urinary urgency and frequency, and worse physical function were associated with more severe bother at 12 months. CONCLUSIONS: Urinary symptom severity at baseline, race, depression and psychological stress were associated with the bother of lower urinary tract symptoms in a prospective cohort of men and women treated at tertiary care facilities. These findings may inform the clinical care of patients with bothersome lower urinary tract symptoms and direct providers to better prognosticate for patients with challenging lower urinary tract symptoms cases.

AB - PURPOSE: Some patients continue to have bothersome lower urinary tract symptoms despite treatment. We examined characteristics associated with bother from lower urinary tract symptoms in a prospective cohort. MATERIALS AND METHODS: In this 1-year prospective, observational cohort study we obtained data on patients with lower urinary tract symptoms who were seeking care at a total of 6 tertiary care centers in the United States. Participants answered the AUA-SI (American Urological Association Symptom Index) global urinary bother question at study entry and 12 months later. Multilevel logistic and linear regression was used to identify factors associated with worsening bother and bother at 12 months, respectively. RESULTS: Of the 756 participants 121 (16%) had worsened lower urinary tract symptom bother during the study period. When adjusted for other variables, worsened lower urinary tract symptom bother was more likely among men who were nonwhite (OR 1.79, 95% CI 0.94-3.40) or who had diabetes (OR 1.68, 95% CI 0.86-3.27) and among women with diabetes (OR 1.77, 95% CI 0.85-3.67), prior treatment of lower urinary tract symptoms (OR 2.58, 95% CI 1.22-5.46) or a higher depression level (OR 1.29, 95% CI 1.10-1.52). Baseline factors associated with more severe bother at 12 months in men included more severe bother at baseline, nonwhite race, worse urinary frequency and incontinence, and higher levels of stress (p <0.05). Among women more severe bother at baseline, urinary urgency and frequency, and worse physical function were associated with more severe bother at 12 months. CONCLUSIONS: Urinary symptom severity at baseline, race, depression and psychological stress were associated with the bother of lower urinary tract symptoms in a prospective cohort of men and women treated at tertiary care facilities. These findings may inform the clinical care of patients with bothersome lower urinary tract symptoms and direct providers to better prognosticate for patients with challenging lower urinary tract symptoms cases.

KW - lower urinary tract symptoms

KW - patient reported outcome measures

KW - population characteristics

KW - prognosis

KW - urinary bladder

UR - http://www.scopus.com/inward/record.url?scp=85071347500&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071347500&partnerID=8YFLogxK

U2 - 10.1097/JU.0000000000000324

DO - 10.1097/JU.0000000000000324

M3 - Article

C2 - 31063049

AN - SCOPUS:85071347500

VL - 202

SP - 585

EP - 591

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 3

ER -