Lifestyle and Progression of Lower Urinary Tract Symptoms in German Men—Results From the EPIC-Heidelberg Cohort

Abstract

To examine if lower urinary tract symptom (LUTS) progression was related to anthropometric and lifestyle factors. The analysis included 5495 men who participated in the EPIC-Heidelberg cohort (recruited 1994-1998) and who reported an International Prostate Symptom Score < 8 at follow-up 4 (FUP4, 2007-2009), had not reported taking α-adrenoreceptor antagonists or 5-α reductase inhibitors or prostate surgery for benign prostatic hyperplasia/LUTS treatment. LUTS progression was defined as an International Prostate Symptom Score ≥ 8 at FUP5 (2010-2012). Using logistic regression analysis, education, marital status, satisfaction with life, satisfaction with health, history of diabetes and of hypertension, smoking, alcohol consumption, body mass index (BMI), waist circumference, and physical activity were examined as potential LUTS risk factors adjusting for age. Increase in BMI between baseline and FUP4 of ≥ 2 BMI units was related to LUTS progression (odds ratio 1.30, 95% confidence interval 1.08-1.57) compared with stable BMI. Compared to men who were very satisfied with life at baseline, those who were satisfied (1.28, 1.11-1.47), unsatisfied (1.80, 1.31-2.46) or very unsatisfied with life (1.43, 0.62-3.34) were more likely to report LUTS progression. Men with longer education had higher odds of LUTS progression than men with primary education only (1.25, 1.06-1.48). Adjusting for BMI or lifestyle factors did not attenuate these associations. Smoking habits, alcohol consumption, physical activity, self-reported history of diabetes or hypertension, and marital status were not related with LUTS progression. Our results confirm some, but not all previously observed risk factors for LUTS progression.