NATURAL-HISTORY OF PROSTATISM - HIGH AMERICAN-UROLOGICAL-ASSOCIATION SYMPTOM SCORES AMONG COMMUNITY-DWELLING MEN AND WOMEN WITH URINARY-INCONTINENCE

The American Urological Association Symptom Index (AUASI) has been rep orted to be nonspecific for benign prostatic hyperplasia. Comparable s cores occur in patients with lower urinary tract symptoms of varying e tiology, and even among women.; The purpose of this study was to deter mine the association between the AUASI and urinary incontinence among community-dwelling men and women. Methods. In 1994, a randomly selecte d cohort of 1540 men and women aged 50 years or older from Olmsted Cou nty, Minnesota completed a self-administered questionnaire that assess ed urinary symptom severity (AUASI score) and estimated the prevalence of urinary incontinence in the previous 12 months. The association be tween moderate to severe urinary symptom (AUASI score greater than 7) and urinary incontinence was investigated using multiple logistic regr ession, with adjustments for gender and age. Results. Mean and median AUASI scores increased with age, and were higher among those responden ts with urinary incontinence and among men. Ail seven urologic items i n the AUASI were more prevalent among respondents with urinary inconti nence and among men. Nocturia was highly prevalent among respondents w ith and without urinary incontinence, but urgency, frequency, and weak urinary stream were more prevalent among respondents with incontinenc e than among respondents without incontinence. When urinary incontinen ce, gender, and age were considered simultaneously, the respondents wi th urinary incontinence (odds ratio [OR] = 4.4, 95% confidence interva l [CI] = 3.4, 5.5), men (OR = 1.9, 95% CI = 1.5, 2.5), and respondents 65 years or older (OR = 1.5, 95% CI = 1.2, 1.9) were more likely to h ave moderate to severe urinary symptoms. Conclusions. Our findings sug gest that men and women with urinary incontinence and older men and wo men are significantly more likely to have moderate to severe urinary s ymptoms. These findings suggest that urinary incontinence may contribu te to a high AUASI score in both sexes. Thus, these data indicate that the similarity in the distribution of the AUASI in men and women is, in part, an artifact introduced by the confounding effects of continen ce status. (C) 1998, Elsevier Science Inc. All rights reserved.