Association of Bowel Habits with Lower Urinary Tract Symptoms in Men: Findings from the 2005–2006 and 2007–2008 National Health and Nutrition Examination Survey

Abstract

Purpose We examine the association between self-reported lower urinary tract symptoms and bowel habits in men in a large, cross-sectional, population based cohort study. Materials and Methods The study included 3,077 men participating in the 2005–2006 or 2007–2008 cycles of the NHANES (National Health and Nutrition Examination Survey) who were 40 years old or older and without a history of prostate cancer. Men were considered to have lower urinary tract symptoms if they reported nocturia, urinary hesitancy and/or incomplete bladder emptying. Bowel habits were characterized by frequency of bowel movements per week and stool consistency based on the Bristol Stool Form Scale. Weighted associations between bowel habits and lower urinary tract symptoms were determined using univariate and multivariate techniques, adjusting for age, race, body mass index, diabetes, alcohol intake, activity level and smoking. Results The prevalence of lower urinary tract symptoms was 37%, with 4% reporting all 3 symptoms. Reporting 3 or fewer bowel movements per week was associated with nocturia (OR 1.67, 95% CI 1.21–2.30), incomplete bladder emptying (OR 2.14, 95% CI 1.06–4.31) and urinary hesitancy (OR 2.06, 95% CI 1.06–4.02). Reporting more than 10 bowel movements per week was associated with nocturia only (OR 1.42, 95% CI 1.01–1.55). Hard (OR 1.76, 95% CI 1.31–2.37) and loose (OR 1.25, 95% CI 1.01–1.55) stool consistency increased the odds of reporting nocturia. Conclusions Lower urinary tract symptoms in the adult male were independently associated with low stool frequency, hard stool type and loose stool type. These data suggest causality or a common pathophysiology of lower urinary tract symptoms and abnormalities of bowel habits.

Best practice policy statement on urodynamic antibiotic prophylaxis in the non‐index patient

“…There is no consensus definition for UTI based on urinalysis . Leukocyte esterase is specific (94‐98%) and reliably sensitive (75‐96%) for detecting uropathogens equivalent to 100,000 colony‐forming units per mL of urine, while nitrite positivity has sensitivity ranging from 35% to 85%, and 95% specificity . The absence of four markers (blood, leukocyte esterase, nitrite, and protein) on the urine dipstick at the point of care had a 98% negative predictive value, with sensitivity of 98.3% and specificity of 19.2% .…”

Lifestyle and lower urinary tract symptoms

“…[5] On a population level, LUTS is a major health burden, and has significant impact on health care cost and productivity in the US. [6] On the individual level, LUTS results in increased risks of mortality, depression, falls and diminished health-related quality-of-life.…”

Nocturia causes vary with each decade

“…Nocturia has also been found to be associated with abnormal bowel habits by Thurmon et al [20] when they examined the 2005-2006 and 2007-2008 NHANES. Although the mechanism is still not understood, nocturia was hypothesized by these authors to be associated with hard, infrequent stooling by direct internal pressure causing reduced nocturnal bladder capacity, excessive night-time urine output, or sleep disorders, in addition to the known bladder and prostate conditions.…”