Reasons for Seeking Clinical Care for Lower Urinary Tract Symptoms: A Mixed Methods Study

Griffith, James W.; Messersmith, Emily E.; Gillespie, Brenda W.; Wiseman, Jonathan B.; Flynn, Kathryn E.; Kirkali, Ziya; Kusek, John W.; Bavendam, Tamara; Cella, David; Kreder, Karl J.; Nero, Jasmine J.; Corona, María Eugenia Jiménez; Bradley, Catherine S.; Kenton, Kimberly; Helfand, Brian T.; Merion, Robert M.; Weinfurt, Kevin P.

doi:10.1016/j.juro.2017.07.067

Cited by 23 publications

(22 citation statements)

References 20 publications

(13 reference statements)

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“…Treatment-seeking behaviour for LUTS is correlated with the symptom severity, degree of bother, costs and bene ts of treatment [40,41]. To the best of our knowledge, this is the rst study to report on the association between awareness of nocturia and treatment-seeking behaviour in Malaysia.…”

Section: Discussionmentioning

confidence: 88%

Prevalence of Nocturia Among Community-dwelling Adults: A Population-based Study in Malaysia

Yow

Tiong²,

Mai

et al. 2020

Preprint

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Background: Nocturia is widely prevalent condition with detrimental effects on quality of life and general health. In Malaysia, there is a lack of up-to-date prevalence study on nocturia. This study aimed to investigate the prevalence of nocturia and awareness pertaining to nocturia among Malaysian adults.Methods: A cross-sectional population-based study was conducted among Malaysian adults aged ≥ 18 years old. The data was collected by mixed mode self-administered questionnaire from May 2019 to September 2019. Nocturia was defined as one or more voids at night.Results: There were a total of 4616 respondents with 74.5% of response rate. The overall prevalence of nocturia among Malaysian adults was found to be 57.3%. In multivariate analysis, respondents aged 31 – 40 (1.91 [1.52 - 2.40]) or > 60 years old (2.03 [1.48 - 2.71]), and those who presented with hypertension (2.84 [2.28 - 3.53]), diabetes mellitus (1.78 [1.42 - 2.25]), renal disease (3.58 [1.93 - 6.63]) or overactive bladder (1.61 [1.10 - 2.35]) were associated with higher prevalence of nocturia. A significantly lower disease prevalence (p < 0.05) was noted among those aged 41 – 50 (0.73 [0.59 - 0.91]), male (0.78 [0.69 - 0.88]) and Chinese (0.47 [0.30 - 0.74]) or Indian (0.34 [0.21 - 0.54]) ethnicities. A total of 37.3% of respondents with nocturia reported that they faced sleeping difficulty about half the time or more after waking up in the middle of night. Those who had ≥ 2 voids per night experienced significantly higher mean bother score than those who had 1 void per night (p < 0.001). Approximately half (56.7%) of all respondents were not aware that night time urination is a medical condition. Only 25.2% of respondents with nocturia had sought medical attention for their nocturia.Conclusion: The prevalence of nocturia among Malaysian adults is high and strongly influenced by age, gender, race and comorbidities. However, the general awareness on nocturia among Malaysians is poor and relates to low treatment-seeking behaviour we found. The findings also highlighted the impact of nocturia on sleep and the need for nocturia education to better address this disease.

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Section: Discussionmentioning

confidence: 88%

Prevalence of Nocturia Among Community-dwelling Adults: A Population-based Study in Malaysia

Yow

Tiong²,

Mai

et al. 2020

Preprint

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“…However, the trigger for seeking medical care for LUTS seems not to be just any lower urinary tract symptom. Curiously, this challenge to early medical care for LUTS seems not peculiar as seen from the review by Roehrborn et al [28] From the reasons given by respondents across all LUTS severity and symptom durations for seeking medical care belatedly, LUTS being non-bothersome ranks highest (Table 3) akin to the observation by Griffith et al [19] So even in low-income economy with poor health insurance coverage, financial constraint does not represent the most prevalent reason for delay in seeking medical care for LUTS in men. To buttress this finding, this study also reveals that respondents' socio-economic status does not have any significant influence on when medical care is sought by men reporting LUTS (Table 4).…”

Section: Discussionmentioning

confidence: 98%

“…LUTS of varying severity and duration are considered nonbothersome by men. In addition, men feel embarrassed discussing their LUTS with someone else including medical care providers [19]. The prevalent challenge to early presentation with LUTS in lowincome setting may not be financial constraints.…”

Section: Introductionmentioning

confidence: 99%

Lower urinary tract symptoms in men: challenges to early hospital presentation in a resource-poor health system

2020

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Background The point at which men seek medical care for lower urinary tract symptoms (LUTS) varies between individuals. Presentation to hospital with complications beyond LUTS appears prevalent in our setting. The aim of this survey is to assess from the community perspective in southeast Nigeria, the challenges to early presentation for medical evaluation for LUTS by men. Methods A questionnaire-based cross-sectional survey of randomly-selected men ≥40 years. The questionnaire captured respondent’s age; presence, duration and severity of LUTS; access to health information; wealth-index; and when (and why) medical care for LUTS was sought. Analysis was with SPSS® version 20. Results In all, responses from 1319 men (mean age 54.2 ± 10.2 years) are analysed. Of these, 267 report LUTS: 58.4% (156) report moderate to severe LUTS and 51.7% (138) are yet to seek medical care. As regards seeking medical care, all the men reporting LUTS of 3 months, 35.7% of 126 men reporting moderate LUTS, and 20.0% of 30 men reporting severe LUTS are yet to seek medical care. LUTS being non-bothersome (not financial constraint) is the most prevalent reason for not seeking medical care early. Delay is encouraged by limited access to health information (OR 3.10; p < 0.001), but discouraged by literacy (OR 0.86; p < 0.001) and aging (OR 0.93; p = 0.002). Conclusion From the community perspective, the prevalent challenge to seeking medical care for LUTS early is absence of bother. Empowering men through formal education and researched health information will influence positively the time that LUTS in men is appreciated as bothersome.

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“…In addition, previous studies conducted within the LURN demonstrate a relationship between symptom bother/severity and treatment-seeking behaviors. 22 …”

Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Urinary Incontinence in a Treatment Seeking Male Prospective Cohort: Results from the LURN Study

et al. 2018

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Purpose: Male urinary incontinence (UI) is thought to be infrequent. We sought to describe the prevalence of UI in a male treatment-seeking cohort enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). Materials and Methods: The inclusion/exclusion criteria, including men with prostate cancer or a neurogenic bladder, have been previously reported. LURN participants prospectively completed questionnaires regarding lower urinary tract symptoms (LUTS) and other clinical variables. Men were grouped based on type of incontinence (1=non-UI; 2=post-void dribbling [PVD] only; 3=UI). Comparisons were made using analysis of variance and multivariable regression. Results: Among 477 men, 24% reported non-UI, 44% PVD only, and 32% UI. Black men and those with sleep apnea were more likely to be in the UI group compared with the non-UI group (odds ratio [OR]=3.2, p=0.02 and OR=2.73, p=0.003, respectively). UI was associated with significantly (p<0.001) higher bother compared to those without leakage. Compared to men without UI and men with PVD only, men with UI were significantly (p<0.01) more likely to report higher scores (more severe symptoms) on patient-reported outcomes measurement information system (PROMIS) questionnaires regarding bowel issues, depression, and anxiety, compared to those without UI. Conclusions: UI is common among treatment-seeking men. This is concerning because the guideline-recommended questionnaires for assessing male LUTS do not query for UI. 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 that provides a more comprehensive symptom assessment.

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Reasons for Seeking Clinical Care for Lower Urinary Tract Symptoms: A Mixed Methods Study

Cited by 23 publications

References 20 publications

Prevalence of Nocturia Among Community-dwelling Adults: A Population-based Study in Malaysia

Prevalence of Nocturia Among Community-dwelling Adults: A Population-based Study in Malaysia

Lower urinary tract symptoms in men: challenges to early hospital presentation in a resource-poor health system

Prevalence and Characteristics of Urinary Incontinence in a Treatment Seeking Male Prospective Cohort: Results from the LURN Study

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