Prevalence and Progression of Lower Urinary Tract Symptoms in an Aging Population

To examine the prevalence of lower urinary tract symptoms (LUTS) in males of the general population.

In our analysis, we included 8627 men, 48-79 years of age, who participated in the fourth follow-up (FUP) of EPIC-Heidelberg (2007-2009) and replied to questions on LUTS. According to the International Prostate Symptom Score questionnaire, men were categorized as having mild (0-7 points), moderate (8-19 points), or severe LUTS (20-35 points). In addition, we examined progression of LUTS among 7821 men, who also participated in FUP 5 (2010-2012).

There were 75.3% of men who reported mild, 22.0% who reported moderate, and 2.7% who reported severe LUTS. The prevalence increased with age. At FUP 4, 5.8% (mild symptoms) to 39.7% (severe LUTS) of participants reported use of any type of benign prostatic hyperplasia or LUTS medication. Nocturia, that is, getting up at night at least twice, was the most common symptom, followed by incomplete emptying of the bladder and urgency. There were 54.8% of men who reported worse LUTS in FUP 5, but 27.1% reported an improvement in symptoms.

About a quarter of middle-aged and elderly men reported clinically relevant LUTS. Whereas symptoms in some men actually improve, more than half of men experience worsening of symptoms over a 3-year period in time.