Prevalence of lower urinary tract symptoms and social determinants in primary care users in Brazil
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Introduction and hypothesis
Although lower urinary tract symptoms (LUTS) have considerable clinical relevance, few propose evaluating its association with social conditions. Our study aimed to evaluate LUTS prevalence in primary care and its association with the social determinants of health (SDH).
This is a cross-sectional study conducted with 322 females in the period of June to October 2016 that carried out consultations and screening to prevent gynecological cancer in a primary care unit.
The ages ranged from 18 to 85 years (M = 40.53). Storage symptoms had a higher overall prevalence (64.6%), highlighting nocturia (n = 186, 57.8%) and urinary incontinence (n = 120, 37.3%). Storage symptoms were associated with three layers of SDH. The voiding and postmicturition symptoms were only related to operative vaginal delivery.
The findings of this study suggest a relationship between SDH and LUTS. It is important to emphasize that the results not only imply a causal relationship, but also point to the social inequalities existing at a population level.
KeywordsLower urinary tract symptoms Social determinants of health Women
We thank CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) and FUNCAP (Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico), Brazilian agencies, for funding the scholarships of the master’s students.
Compliance with ethical standards
Conflicts of interest
- 1.Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21:5–26. https://doi.org/10.1007/s00192-009-0976-9.CrossRefPubMedGoogle Scholar
- 3.Abrams P, Cardozo L, Khoury S, Wein A. Incontinence. Tokyo: ICS/ICUD; 2016.Google Scholar
- 5.Zhang L, Zhu L, Xu T, Lang J, Li Z, Gong J, et al. A population-based survey of the prevalence, potential risk factors, and symptom-specific bother of lower urinary tract symptoms in adult Chinese women. Eur Urol. 2015;68(1):97–112. https://doi.org/10.1016/j.eururo.2014.12.012.CrossRefPubMedGoogle Scholar
- 7.Agarwal A, Eryuzlu LN, Cartwright R, Thorlund K, Tammela TL, Guyatt GH, et al. What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women. Eur Urol. 2014;65(6):1211–7. https://doi.org/10.1016/j.eururo.2014.01.019.CrossRefPubMedPubMedCentralGoogle Scholar
- 11.World Health Organization-WHO (2010) Closing the Gap on a Generation: Health Equity Through Action on the Social Determinants of Health. Commission on Social Determinants of Health (CSDH). Geneva, 2010. http://apps.who.int/iris/bitstream/10665/43943/1/9789241563703_eng.pdf Accessed 30 Sept 2017.
- 13.Dahlgren G, Whitehead M (2007) Policies and strategies to promote social equity in health. Background document to WHO-Strategy paper for Europe. Stockholm: Stockholm Institute for Further Studies https://pdfs.semanticscholar.org/2537/7200786dcbdb7889cf4123bfeab5377c13d1.pdf. Accessed 30 Sept 2017.
- 15.Associação Brasileira de Empresas de Pesquisa – ABEP (2015) Critério de Classificação Econômica Brasil. file:///C:/Users/Ibyte/Downloads/01_cceb_2016_11_04_16_final.pdf. Accessed 30 Sept 2017.Google Scholar
- 16.Pålsson M, Stjerndahl JH, Granåsen G, Löfgren M, Sundfeldt K. Patient-reported lower urinary tract symptoms after hysterectomy or hysteroscopy: a study from the Swedish quality register for gynecological surgery. Int Urogynecol J. 2017;28:1341–9. https://doi.org/10.1007/s00192-017-3268-9.CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Moreira ED Jr, Neves RCS, Neto AF, Duarte FG, Moreira TL, Lobo CFL, et al. Population-based survey of lower urinary tract symptoms (LUTS) and symptom-specific bother: results from the Brazilian LUTS epidemiology study (BLUES). World J Urol. 2013;31(6):1451–8. https://doi.org/10.1007/s00345-013-1057-8.CrossRefPubMedGoogle Scholar
- 20.Crane AK, Geller EJ, Bane H, Ju R, Myers E, Matthews CA. Evaluation of pelvic floor symptoms and sexual function in Primiparous women who underwent operative vaginal delivery versus cesarean delivery for second-stage arrest. Female Pelvic Med Reconstr Surg. 2013;19(1):13–6. https://doi.org/10.1097/SPV.0b013e31827bfd7b.CrossRefPubMedPubMedCentralGoogle Scholar