Abstract
Purpose
To better understand potential modifiable risk factors guiding preventive interventions against lower urinary tract symptoms (LUTS).
Methods
A prospective cross-sectional study, including healthy men aged 40–70 years under routine urological evaluation, measured the strength of association between the International Prostate Symptom Score (IPSS) and socio-demographic, lifestyle, and health-related factors using logistic and linear regression adjusted for confounding factors. Men with urethral or prostate surgery were excluded.
Results
Among 743 men, mean age 59.64 ± 9.66, 22.6% reported moderate, and 5.0% severe LUTS. The adjusted odds of severe LUTS increased with: increasing age (OR = 1.07, 95% CI = 1.05–1.09, p < .0001), increasing prostate volume (OR = 1.02, 95% CI = 1.01–1.04, p = .004), decreasing education (tertiary qualification, no versus yes, OR = 2.34; 95% CI = 1.16–4.70; p = .0133), delayed ejaculation (yes versus no, OR = 2.63, 95% CI = 1.43–4.83, p < .0001), and increasing blood pressure (systolic ≥130 mmHg, OR = 2.03, 95% CI = 1.44–2.86, p < .0001 or diastolic ≥85 mmHg, OR = 1.47, 95% CI = 1.03–2.10, p = .0345); severe LUTS decreased with: increasing the weekly sexual frequency (OR = 0.80, 95% CI = 0.69–0.91, p = .0012) and increasing HDL cholesterol (OR = 0.98, 95% CI = 0.97–0.99, p = .037). Odds were not significant for age of sexual initiation, precocious ejaculation, masturbatory pattern, physical activity, smoking, alcohol consumption, penile length (objective and subjective), abdominal circumference, obesity, comorbid conditions, metabolic syndrome, serum glycaemia, testosterone, SHBG, PSA, and estradiol.
Conclusions
One in every four men under routine urological evaluation who considered themselves healthy present moderate and severe LUTS. Modifiable behavioral (education, sexual frequency, and ejaculation) and health-related (blood pressure and HDL cholesterol) targets were identified for future interventional studies and potential preventive actions and patient counseling.
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Current study is in accordance with the institutional ethical standards, approval number 543.095, and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Funding
CAPES, Brazil—Grant: BEX 14679/13-2. CNPq Research Productivity, Brazil—Grant: 302622/2015-2.
Additional information
O. Ikari and B. C. F. Sanches equally contributed to this work.
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Ikari, O., Sanches, B.C.F., Alonso, J.C.C. et al. Is there room for behavioral and modifiable health-related targets in the lower urinary tract symptoms’ scenario. World J Urol 35, 1451–1454 (2017). https://doi.org/10.1007/s00345-016-1999-8
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DOI: https://doi.org/10.1007/s00345-016-1999-8