Relative Impact of Male Urinary Conditions on Overall Quality of Life.

Abstract

Objectives: To assess the impact of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH) and other urinary conditions on quality of life (QoL), in comparison to other comorbidities, after adjusting for lifestyle and demographic factors.

Methods: The BPH Registry and Patient Survey is a multicenter, longitudinal, observational database of management practices and patient outcomes in a population of 6924 patients with BPH in the USA, managed with watchful waiting or pharmacotherapy. QoL was assessed using the Medical Outcomes Study-Short Form 12 physical (SF12 PCS) and mental health (SF12 MCS) component scores. The following urinary conditions were evaluated: lower urinary tract symptoms (LUTS) assessed using the International Prostate Symptom Score (IPSS), physician diagnosed urinary incontinence (UI), overactive bladder (OAB) and urinary tract infection (UTI). Associations between QoL and urinary conditions and other co-morbidities adjusted for demographic/lifestyle factors were estimated in 3818 men with complete data using linear regression models.

Results: Approximately 21.1% of the population reported having at least one urinary condition; however, prevalence of specific urinary conditions was less than other co-morbidities. After adjusting for age, marital status, education, income, employment, alcohol use and smoking status, severe LUTS (IPSS ≥ 20) and UI were associated with a 3.9- and 2.9-point decrease in the SF12 PCS, respectively. These associations were similar to those observed with arthritis and depression, and more significant than the PCS reductions associated with cardiovascular disease (CVD), cancer, and diabetes. Urinary conditions also led to greater reductions in the SF12 MCS compared to other comorbidities, with only depression showing a greater impact on MCS scores.

Conclusions: These results highlight that the impact of urinary conditions, particularly LUTS and UI, on QoL is similar to, if not more substantial than, that of other major chronic diseases. These conditions affect not only the physical component of QoL but also significantly influence the mental domains.