Brian T Helfand1, Abigail R Smith2, H Henry Lai2, Claire C Yang2, John L Gore2, Brad A Erickson2, Karl J Kreder2, Anne P Cameron2, Kevin P Weinfurt2, James W Griffith2, Aaron Lentz2, Pooja Talaty2, Victor P Andreev2, Ziya Kirkali2. 1. NorthShore University Health System (BTH, PT), Evanston, Illinois; Feinberg School of Medicine, Northwestern University (JWG), Chicago, Illinois; Arbor Research Collaborative for Health (ARS, VPA), Ann Arbor, Michigan; University of Michigan (APC), Ann Arbor, Michigan; Washington University School of Medicine (HHL), St. Louis, Missouri; University of Washington (CCY, JLG), Seattle, Washington; Department of Urology, University of Iowa (KJK), Iowa City, Iowa; Duke University Medical Center (KPW, AL), Durham, North Carolina; National Institute of Diabetes and Digestive and Kidney Diseases (ZK), Bethesda, Maryland. Electronic address: bhelfand@northshore.org. 2. NorthShore University Health System (BTH, PT), Evanston, Illinois; Feinberg School of Medicine, Northwestern University (JWG), Chicago, Illinois; Arbor Research Collaborative for Health (ARS, VPA), Ann Arbor, Michigan; University of Michigan (APC), Ann Arbor, Michigan; Washington University School of Medicine (HHL), St. Louis, Missouri; University of Washington (CCY, JLG), Seattle, Washington; Department of Urology, University of Iowa (KJK), Iowa City, Iowa; Duke University Medical Center (KPW, AL), Durham, North Carolina; National Institute of Diabetes and Digestive and Kidney Diseases (ZK), Bethesda, Maryland.
Abstract
PURPOSE: Male urinary incontinence is thought to be infrequent. We sought to describe the prevalence of urinary incontinence in a male treatment seeking cohort enrolled in the LURN (Symptoms of Lower Urinary Tract Dysfunction Research Network). MATERIALS AND METHODS: Study inclusion and exclusion criteria, including men with prostate cancer or neurogenic bladder, were previously reported. LURN participants prospectively completed questionnaires regarding lower urinary tract symptoms and other clinical variables. Men were grouped based on incontinence type, including 1) no urinary incontinence, 2) post-void dribbling only and 3) urinary incontinence. Comparisons were made using ANOVA and multivariable regression. RESULTS: Of the 477 men 24% reported no urinary incontinence, 44% reported post-void dribbling only and 32% reported urinary incontinence. African American men and those with sleep apnea were more likely to be in the urinary incontinence group than in the no urinary incontinence group (OR 3.2, p = 0.02 and OR 2.73, p = 0.003, respectively). Urinary incontinence was associated with significantly higher bother compared to men without leakage (p <0.001). Compared to men without urinary incontinence and men with only post-void dribbling those with urinary incontinence were significantly more likely to report higher scores (more severe symptoms) on the PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaires regarding bowel issues, depression and anxiety than men without urinary incontinence (p <0.01). CONCLUSIONS: Urinary incontinence is common among treatment seeking men. This is concerning because the guideline recommended questionnaires to assess male lower urinary tract symptoms do not query for urinary incontinence. Thus, clinicians may be missing an opportunity to intervene and improve patient care. This provides a substantial rationale for a new or updated symptom questionnaire which provides a more comprehensive symptom assessment.
PURPOSE:Male urinary incontinence is thought to be infrequent. We sought to describe the prevalence of urinary incontinence in a male treatment seeking cohort enrolled in the LURN (Symptoms of Lower Urinary Tract Dysfunction Research Network). MATERIALS AND METHODS: Study inclusion and exclusion criteria, including men with prostate cancer or neurogenic bladder, were previously reported. LURN participants prospectively completed questionnaires regarding lower urinary tract symptoms and other clinical variables. Men were grouped based on incontinence type, including 1) no urinary incontinence, 2) post-void dribbling only and 3) urinary incontinence. Comparisons were made using ANOVA and multivariable regression. RESULTS: Of the 477 men 24% reported no urinary incontinence, 44% reported post-void dribbling only and 32% reported urinary incontinence. African American men and those with sleep apnea were more likely to be in the urinary incontinence group than in the no urinary incontinence group (OR 3.2, p = 0.02 and OR 2.73, p = 0.003, respectively). Urinary incontinence was associated with significantly higher bother compared to men without leakage (p <0.001). Compared to men without urinary incontinence and men with only post-void dribbling those with urinary incontinence were significantly more likely to report higher scores (more severe symptoms) on the PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaires regarding bowel issues, depression and anxiety than men without urinary incontinence (p <0.01). CONCLUSIONS:Urinary incontinence is common among treatment seeking men. This is concerning because the guideline recommended questionnaires to assess male lower urinary tract symptoms do not query for urinary incontinence. Thus, clinicians may be missing an opportunity to intervene and improve patient care. This provides a substantial rationale for a new or updated symptom questionnaire which provides a more comprehensive symptom assessment.
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