NATURAL-HISTORY OF PROSTATISM - FACTORS ASSOCIATED WITH DISCORDANCE BETWEEN FREQUENCY AND BOTHER OF URINARY SYMPTOMS

The objective of this study was to assess the association between freq uency and bother of urinary symptoms in a population-based cohort of m en and to identify psychosocial factors that are related to reporting heightened or subdued bother relative to symptom frequency. The survey was conducted among men aged forty to seventy-nine years in Olmsted C ounty, Minnesota, the baseline component of a prospective cohort study . Men were queried about the frequency of urinary symptom occurrence a nd the perceived bother associated with the symptoms. A regression ana lysis of American Urologic Association (AUA) bother scores on AUA freq uency scores demonstrated a tight correspondence (r(2) = 0.71). Men wi th bother scores greater than predicted from their frequency scores we re more likely to have sought health care for their urinary symptoms t han men whose bother was close to predicted (14 versus 5 percent, resp ectively). These men with heightened bother were older, poorer, more a nxious, and had lower general psychologic well-being scores than the m en whose bother was similar to that expected from their reported frequ ency. Men whose bother was lower than would be expected were less like ly to have sought health care for urinary symptoms in the past year (3 %) but were of similar age and socioeconomic status as compared with m en whose bother was close to expected. These men, however, were more d epressed than men whose bother was commensurate with reported frequenc y. While the men who reported greater bother than expected from their symptom frequency were more likely to have sought medical care for uri nary symptoms in the past year, it is not clear whether this greater h ealthcare-seeking behavior is because bother captures an additional co mponent of urologic disease or is a manifestation of psychosocial diff erences.