Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/82421
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Type: Journal article
Title: Risk factors for progression or improvement of lower urinary tract symptoms in a prospective cohort of men
Author: Martin, S.
Lange, K.
Haren, M.
Taylor, A.
Wittert, G.
Citation: Journal of Urology, 2014; 191(1):130-137
Publisher: Lippincott Williams & Wilkins
Issue Date: 2014
ISSN: 0022-5347
1527-3792
Statement of
Responsibility: 
Sean Martin, Kylie Lange, Matthew T. Haren, Anne W. Taylor, Gary Wittert, Members of the Florey Adelaide Male Ageing Study
Abstract: PURPOSE We determined the metabolic, lifestyle and physical factors associated with progression or improvement of storage and voiding lower urinary tract symptoms in a population based cohort of men. MATERIALS AND METHODS After the exclusion of men with prostate or bladder cancer and/or surgery from the study, progression and improvement of storage and voiding lower urinary tract symptoms was assessed using the AUA-SI (American Urological Association symptom index) in 780 men, age 35 to 80 years at baseline, who attended 5-year followup clinics. RESULTS Storage and voiding lower urinary tract symptoms progressed in 39.8% (308) and 32.3% (250) of men, and improved in 33.1% (256) and 23.4% (181), respectively. In final adjusted regression models greater bother and physical activity at baseline predicted improvement in storage and voiding lower urinary tract symptoms, while greater income, high-density lipoprotein cholesterol and lower triglycerides predicted improvement of storage lower urinary tract symptoms only. Being widowed, higher plasma estradiol and depression at baseline predicted the progression of storage and voiding lower urinary tract symptoms, while greater abdominal fat mass and obstructive sleep apnea risk predicted the progression of storage lower urinary tract symptoms only. Older age, lower high-density lipoprotein cholesterol, testosterone, income, previous benign prostatic hyperplasia and erectile dysfunction at baseline predicted the progression of voiding lower urinary tract symptoms only. The initiation or continued use of α-blockers or anticholinergics (storage lower urinary tract symptoms), and 5α-reductase inhibitors (voiding lower urinary tract symptoms), were associated with symptom improvement. CONCLUSIONS Lower urinary tract symptoms may progress or remit. Even accounting for medication use, progression may be associated with modifiable disease, or metabolic or behavioral factors, which are also risk factors for type 2 diabetes and cardiovascular disease. These factors should be looked for and managed.
Keywords: Prostatism; epidemiology; urinary tract physiological phenomena; cohort studies; men’s health
Rights: © 2014 by American Urological Association Education and Research, Inc.
RMID: 0020134411
DOI: 10.1016/j.juro.2013.06.018
Published version: http://www.jurology.com/article/S0022-5347(13)04604-1/abstract
Appears in Collections:Medicine publications

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