What determines whether a patient with LUTS seeks treatment? ICI-RS 2011

To review the known determinants of healthcare-seeking behavior for LUTS and address unmet needs and future research priorities.

The PubMed literature was searched for currently known factors affecting treatment seeking for LUTS, OAB, and incontinence in men and women.

Further to the great variation in rates for treatment seeking for LUTS in both men and women, several biomedical and psychosocial factors affecting HSB have been identified in studies to date. Symptom severity and bother, age, and impact on quality of life have consistently been identified as potent determinants of treatment seeking for LUTS. Race and ethnicity also play a role. Advice from others and the media, embarrassment, personal beliefs and attitudes towards healthcare use, and subjective well-being are but a few of the psychosocial determinants which may impact on a patient's decision to seek medical advice for LUTS. Studying the role of reassurance versus medical treatment, referral patterns for LUTS in various populations, the role of comorbidities in HSB, cultural issues, bother-associated parameters and psychosocial profiles in association with healthcare-seeking, patients' expectations, HSB in relation to health economics, and development of questionnaires on HSB for patients and physicians should be amongst future research priorities.

Increasing research interest has helped identify several biomedical and psychosocial factors affecting HSB for LUTS. Qualitative research is needed as well as studies to address aspects of HSB, not only in subjects attending the available healthcare services, but even more in those patients who do not seek medical advice for their LUTS.