Faculty Collaboration Database

Relationship of symptom severity and bother in individuals seeking care for lower urinary tract symptoms. Neurourol Urodyn 2020 Nov;39(8):2161-2170

Date

08/08/2020

Pubmed ID

32761962

Pubmed Central ID

PMC8327284

DOI

10.1002/nau.24466

Scopus ID

2-s2.0-85089030088 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

AIMS: Bother attributed to lower urinary tract symptoms (LUTS) drives care-seeking and treatment aggressiveness. The longitudinal relationship of LUTS severity and bother in a care-seeking cohort, however, is not well understood. We aim to conduct a longitudinal evaluation of LUTS severity and bother and identify characteristics of patients with discordant LUTS bother relative to severity.

METHODS: Men and women with LUTS seeking care at six US tertiary care centers enrolled in the symptoms of lower urinary tract dysfunction research network study. Patients reporting at least one urinary symptom based on the LUTS Tool were prospectively enrolled from June 2015 to January 2017. Correlations were used to assess the relationship between LUTS severity and bother. Discordance scores (ie, the difference between bother and severity) were used to classify patients with high and low bother. Patients were classified as having high or low bother phenotypes if scores were one standard deviation above or below zero, respectively. Repeated measures multinomial logistic regression evaluated characteristics associated with high and low bother phenotypes.

RESULTS: LUTS severity and bother were at least moderately correlated for all symptom items and highly correlated for 13 out of 21 items. Correlations were highest for urgency, and lowest for daytime frequency and urinary incontinence. Odds of being in high bother phenotype were lowest at 3 and 12 months (3 months vs baseline odds ratio [OR] = 0.71, 95% confidence ninterval [CI] = 0.54-0.94; 12 months vs baseline OR = 0.66, 95% CI = 0.48-0.91), and highest for those who endorsed all urgency questions (OR = 3.65, 95% CI = 2.17-6.13). Odds of being in the low bother phenotype were lowest for patients who endorsed all urgency items (OR = 0.33, 95% CI = 0.26-0.42), and all frequency items (OR = 0.68, 95% CI = 0.53-0.88).

CONCLUSIONS: LUTS severity and bother correlate highly and measurement of both in clinical practice is likely redundant. There are patient factors associated with discordance which may justify additional evaluation.

Author List

Agochukwu-Mmonu N, Wiseman JB, Smith AR, Helmuth ME, Sarma AV, Cameron AP, Amundsen CL, Flynn KE, Cella D, Weinfurt KP, Kirkali Z, Clemens JQ

Author

Kathryn Eve Flynn PhD Vice Chair, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Female
Humans
Lower Urinary Tract Symptoms
Male
Middle Aged
Patient Acceptance of Health Care
Prevalence
Severity of Illness Index
Young Adult