Epidemiologic survey of lower urinary tract symptoms in Japan

A large-scale nationwide epidemiologic survey was performed to determine the prevalence of lower urinary tract symptoms (LUTS) and their impact on health-related quality of life (HRQOL) in Japan.

A self-administered questionnaire was mailed to 10,096 randomly selected Japanese men and women aged 40 years or older. The survey questions, developed by the Japan Neurogenic Bladder Society, encompassed four areas: demographic characteristics, LUTS, HRQOL, and treatment seeking. A modified King's Health Questionnaire was used to evaluate HRQOL. Correlations among the response scores were analyzed by Spearman's rank test.

The responses from 4570 subjects (mean age 61 years) were analyzed. The prevalence rate for daytime urinary frequency of 8 and 11 times or more daily was 50% and 11%, respectively. The prevalence of nocturia occurring 1 and 3 or more times/night was 69% and 14%, respectively. For other symptom frequency (ie, weak urine flow, sensation of residual urine, bladder pain, urinary urgency, urgency incontinence, stress incontinence, and incontinence pad use), the prevalence rates ranged from 2% to 27% for 1 or more times/wk and 1% to 20% for 1 or more times/day. Emotions and sleep/energy were most affected by LUTS (10% each), followed by physical limitations (7%), role limitations (6%), social limitations (4%), and personal relationships (3%). Nocturia was most frequently (38%) reported to have the greatest impact on HRQOL. Of those who considered their daily life to be affected by LUTS, only 18% sought medical care.

Although LUTS are highly prevalent in Japan, few subjects seek treatment. Greater awareness and understanding of LUTS is needed to manage symptoms and their consequences appropriately.