New Concepts in Epidemiology of Lower Urinary Tract Symptoms in Men

Abstract

Context Recent insights into the pathophysiology of lower urinary tract symptoms (LUTS) have led to the introduction of new concepts, such as postmicturition LUTS as a third category alongside voiding and storage LUTS; the consideration of the lower urinary tract as a functional unit, in view of the importance of the role of the bladder in LUTS; and the realization that the prevalence of LUTS is similar in the two genders. Objective Verify whether epidemiologic information supports these concepts. Evidence acquisition Four important epidemiologic studies—the International Continence Society “Benign Prostatic Hyperplasia” (ICS-BPH) study, the EPIC survey, the Boston Area Community Health (BACH) survey, and the Epidemiology of LUTS (EpiLUTS) survey—were identified and reviewed. Evidence synthesis The epidemiologic findings not only support these concepts but also have provided additional information that should be borne in mind for the management of LUTS. Findings include the facts that voiding symptoms are more common in men and storage symptoms are more common in women, that the prevalence of LUTS does not differ by race, and that treatment seeking by patients with LUTS is very low. In addition, LUTS have been found to be associated with chronic diseases. This observation may lead to insights into the pathophysiology of LUTS. Conclusion Epidemiologic studies support the new concepts.