Abstract
IntroductionLower urinary tract symptoms (LUTS), which encompass storage, voiding, and postmicturition symptoms, are highly prevalent and recognized globally. Based on a nationwide population-based database, this study tests the hypothesis that medical attendance for LUTS is associated with a subsequent increase in the number of outpatient visits and hospitalizations, with differences among medical specialties and age groups.MethodsParticipants were selected from a random population sample of approximately one million people as a representative cohort of National Health Insurance (NHI) enrollees in Taiwan. Participants had at least three outpatient service claims with a coding of LUTS during the recruitment period 2001–2004. Both the LUTS group and non-LUTS control group were monitored for subsequent outpatient visits and hospitalizations, excluding LUTS-related healthcare services, for 2 years following the index date. The results were categorized based on medical specialty and age group.ResultsThe outpatient visit rates (no. per person-year) and adjusted incidence rate ratios (IRRs) (95% confidence interval (CI) were significantly higher in urology (4.51, 95%CI 4.15–4.91) and gynecology (1.82, 95%CI 1.76–1.89) for the LUTS group. They were also significantly high in other departments, including internal medicine (1.25), general practice (1.13), Chinese medicine (1.77), family medicine (1.19), surgery (1.38), and psychiatry (1.98). Similarly, the hospitalization rate (no. per 1000 person-year) and adjusted IRRs (95% CI) were significantly higher in urology (5.50, 95% CI = 4.60–6.50) and gynecology (1.60, 95% CI = 1.35–1.90), as well as in internal medicine (1.55) and surgery (1.56), but not in psychiatry (1.12). Furthermore, the IRRs differed among 3 age groups.ConclusionsA significantly higher number of outpatient visits and hospitalizations were observed for individuals with LUTS, compared to the control group, and the effects differed with the advancement of age. This study broadens understanding of LUTS by viewing their impact on healthcare services with multiple and overlapping systems, rather than considering them exclusively as symptoms of traditional diseases of the bladder and urethra.
Highlights
Lower urinary tract symptoms (LUTS), which encompass storage, voiding, and postmicturition symptoms, are highly prevalent and recognized globally
According to the EPIC epidemiology study conducted in five European countries using definitions established by the 2002 International Continence Society (ICS), the existence of LUTS was as high as 64.3%, with a total of 19,165 people having at least one of the symptoms
The participants were matched for age, gender, HTN, DM in the LUTS group and the control group
Summary
Lower urinary tract symptoms (LUTS), which encompass storage, voiding, and postmicturition symptoms, are highly prevalent and recognized globally. Lower urinary tract symptoms (LUTS) is an umbrella term that encompasses all urinary symptoms, including storage, voiding, and postmicturition symptoms [1]. The prevalence of LUTS increases with age among the general population [2,3,4]. Nocturia was the most common of the LUTS, (48.6% in men and 54.5% in women). Storage, voiding, and postmicturition symptoms was 51.3%, 25.7%, and 16.9% in men and 59.2%, 19.5%, and 14.2% in women, respectively. Rates were similar between men and women and increased with the advancement of age. By 2018, an estimated 2.3 billion people will be affected by at least one of the LUTS (an 18.4% increase), 546 million by OAB (20.1%), 423 million by urinary incontinence (UI) (21.6%), and 1.1 billion by LUTS/
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