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Urgency and other lower urinary tract symptoms in men aged ≥ 40 years: A Belgian epidemiological survey using the ICIQ-MLUTS questionnaire

By D. De Ridder, T. Roumeguère, and L. Kaufman

International Journal of Clinical Practice

Volume 69, Issue 3, 1 March 2015, Pages 358-365

Editorial comment
In this article the authors show the results of a Belgian epidemiological study on urgency and other lower urinary tract symptoms (LUTS) in males. A population-based survey was conducted among 124 Belgian general practitioners to collect data on LUTS of men aged ≥ 40 yrs during a regular visit for any reason. These men were asked to fill in the International Consultation on Incontinence Modular Questionnaire – Male LUTS (ICIQ-MLUTS) assessing the prevalence and bother of 13 urinary symptoms (bladder filling and emptying symptoms) as experienced over the past four weeks. The bother of each of the 13 symptoms was scored on a scale from 0 (not at all) to 10 (great deal). In addition to the ICIQ-MLUTS, men were asked to rate the impact of LUTS on QoL on a scale from 0 (not at all) to 3 (very much) by answering the question: “How much does the bladder bother you during everyday life?” Analysis of data was performed in 5890 men. Nocturia, defined as having to get up more than once during the night to urinate, was the most prevalent (69.2%) and the most bothersome symptom, with 15.1% of all men having a nocturia bother score ≥ 5. Prevalence of nocturia increased with age and was observed in 41.6% of men aged 40–49 yrs and in 61.9% of men aged 50–59 yrs, while reaching 88.7% and 91.5% in patients 70–79 and ≥ 80 yrs, respectively. Urgency was considered as the second most bothersome symptom and was reported by 58.3% of men.

This survey was performed among men visiting a general practitioner for any reason, a fact that could not be representative of the general population of all men aged ≥ 40 years, as individuals with medical problems could have been overrepresented. Nevertheless, this is the first study using the ICIQ-Male LUTS Questionnaire to assess LUTS in a population-based survey. The strength of this validated questionnaire, with grade A recommendation from International Consultation on Incontinence, is that it provides an assessment of LUTS in combination with their impact on QoL. The results of the present study increase the awareness, for both physicians and patients, of the presence and bother of LUTS and particularly of OAB symptoms as well as nocturia. This might increase the identification of these conditions, finally leading to an improved diagnosis and management.

Summary

Background and Aims

The aim of this study was to assess prevalence and associated bother of male lower urinary tract symptoms (LUTS), especially of urgency and other storage symptoms, since these are generally assumed to be underdiagnosed/undertreated in men.

Methods

Data on bladder condition of men ≥ 40 years were prospectively collected by 124 general practitioners (GPs) during a regular visit for any reason, using the validated ICIQ-MLUTS questionnaire. For 13 symptoms, prevalence (scale 0–4) and bother (scale 0–10) were scored. General bladder-related quality of life (scale 0–3) was also assessed.

Results

Data from 5890 men (mean age: 61.2 years) were analysed. A total of 7.7% had urgency most or all of the time (score ≥ 3) and 6.2% had bothersome urgency (score ≥ 3 + bother score ≥ 5). Nocturia (69.2%) and urgency (58.3%) were the most prevalent and bothersome symptoms. Both prevalence and bother of all LUTS increased with age. Additionally, 28.9% of men reported to be a little bothered by their bladder condition in everyday life, while 11.9% were bothered a lot/very much (2.5% in age group 40–49 years increasing to 29.2% in those > 80 years).

Conclusions

In the general population of men ≥ 40 years who visited a GP for any reason, 41% indicated to be at least a little bothered by their bladder condition. The prevalence of LUTS, especially nocturia and urgency, is high and a significant number of men indicated to be seriously bothered. Increasing awareness of male LUTS, and storage symptoms in particular, is warranted to discuss management options that could increase quality of life.

Keywords: Quality of life, bladder, aging, lower urinary tract symptoms, nocturia