1727 THE ASSOCIATION OF POSTTRAUMATIC STRESS DISORDER WITH LOWER URINARY TRACT SYMPTOMS IN MALE IRAQ AND AFGHANISTAN VETERANS

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology and Natural History/Evaluation and Markers1 Apr 20121727 THE ASSOCIATION OF POSTTRAUMATIC STRESS DISORDER WITH LOWER URINARY TRACT SYMPTOMS IN MALE IRAQ AND AFGHANISTAN VETERANS Benjamin Breyer, Beth Cohen, Daniel Berterthal, Raymond Rosen, Thomas Neylan, and Karen Seal Benjamin BreyerBenjamin Breyer San Francisco, CA More articles by this author , Beth CohenBeth Cohen San Francisco, CA More articles by this author , Daniel BerterthalDaniel Berterthal San Francisco, CA More articles by this author , Raymond RosenRaymond Rosen Watertown, MA More articles by this author , Thomas NeylanThomas Neylan San Francisco, CA More articles by this author , and Karen SealKaren Seal San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1688AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The main aim of this study was to examine the association between posttraumatic stress disorder (PTSD) and Lower Urinary Tract Symptoms (LUTS) in male Iraq and Afghanistan veterans. METHODS This retrospective study used a Department of Veteran Affairs (VA) administrative database of Iraq and Afghanistan veterans enrolled in VA healthcare following military service separation between 10/07/01 through 09/30/11. ICD-9 diagnostic codes were used to identify PTSD and LUTS. Health services utilization and prescription medication data were also obtained. Descriptive statistics were used to compare the prevalence of LUTS in veterans with and without PTSD and generalized linear models were used to examine associations between PTSD and LUTS, utilization of urology services, and the prescription of medications for LUTS. RESULTS The median age of 643,599 Iraq and Afghanistan veterans in VA healthcare was 26 years; the prevalence of PTSD and LUTS during the study period was 28.5% and 1.6%, respectively. Male veterans with PTSD compared to those without PTSD were more likely to suffer from LUTS (2.9% versus 1.1%, p<.001). Veterans with PTSD compared to those without PTSD were also more likely to receive prescriptions for an alpha blocker or 5 alpha-reductase inhibitor (1.7% versus 0.7%, p<.001) and they were more likely to have attended a urology clinic (8.1% versus 3.6%, p<.001). In a generalized linear model adjusted for sociodemographic, military service characteristics, and spinal cord injury, PTSD independently increased the relative risk of LUTS by nearly three times [adjusted relative risk (ARR)=2.81, 95% Confidence Interval (CI) = 2.7-2.92]. After additional adjustment for medications used to treated PTSD (e.g. selective serotonin uptake inhibitors and other psychoactive medication) and urology clinic visit history, the relative risk of LUTS decreased, but was still significantly associated with PTSD (ARR=1.19, 95% CI= 1.12-1.26). CONCLUSIONS LUTS is prevalent among Iraq and Afghanistan veterans enrolled in VA healthcare who have received PTSD diagnoses. While medications used in the treatment of PTSD may contribute to LUTS, PTSD and/or autonomic dysregulation associated with PTSD also appears to independently increase the likelihood of LUTS. Awareness of the significant association between PTSD and LUTS may stimulate more research and improved treatments for this important quality of life issue. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e696 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Breyer San Francisco, CA More articles by this author Beth Cohen San Francisco, CA More articles by this author Daniel Berterthal San Francisco, CA More articles by this author Raymond Rosen Watertown, MA More articles by this author Thomas Neylan San Francisco, CA More articles by this author Karen Seal San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...