NATURAL-HISTORY OF PROSTATISM - IMPAIRED HEALTH STATES IN MEN WITH LOWER URINARY-TRACT SYMPTOMS

Purpose: Lower urinary tract symptoms are reported to have a significa nt impact on quality of life. However, the impact on specific aspects of health status is not clear. We evaluated the association between lo wer urinary tract symptoms, and physical and mental aspects of health using community based data from a cross-sectional component of a prosp ective cohort study. Materials and Methods: A total of 2,133 men 41 to 84 years old who were randomly selected from the Olmsted County, Minn esota population completed the 36-item health status questionnaire and a previously validated questionnaire assessing urinary symptoms. Eigh t domains, measured on a scale of 0 to 100, were used to assess genera l health status. Men were classified as having an impaired health stat us if they scored less than 75 points on the scale. Symptom severity ( none, mild, moderate or severe) was measured from responses to the uri nary symptom questionnaire. Results: The results demonstrated a cross- sectional decrease in mean health status scores for all 8 domains acro ss levels of increasing urinary symptom severity. The strongest associ ations between health status scores and urinary symptoms (severe versu s none) were observed for role limitation due to physical problems (od ds ratio 15.7, 95% confidence interval 6.6 to 37.0), energy/fatigue (o dds ratio 9.2, 95% confidence interval 4.7 to 18.1), role limitation d ue to emotional problems (odds ratio 8.7, 95% confidence interval 4.1 to 18.2) and general perception of health (odds ratio 7.2, 95% confide nce interval 3.8 to 13.4). For these 4 dimensions men with mild urinar y symptoms were also significantly more likely to have an impaired hea lth status. Adjustment for age and co-morbidity did not alter the resu lts. Conclusions: These findings suggest that urinary symptoms have a multidimensional association with physical and mental aspects of healt h. Although lower urinary tract symptoms may be the cause of an impair ed health status, men with impaired health conditions may be more sens itive to prevalent urinary symptoms and more likely to report them. Wh ile the casual nature of this association has not been ascertained, th ese results may help to identify appropriate health dimensions to asse ss in patients with lower urinary tract symptoms.