Lower Urinary Tract Symptoms in People Experiencing Homelessness: An Exploratory Study in a Miami Street Medicine...

To explore the prevalence and severity of lower urinary tract symptoms (LUTS), prior urologic diagnosis, and the impact of bathroom access among people experiencing homelessness (PEH) in Miami, FL. This study attempts to provide insight into understudied disease burden in this marginalized population.

A cross-sectional survey was conducted via Miami Street Medicine using the International Prostate Symptom Score (IPSS) and the Urogenital Distress Inventory-6 (UDI-6). Participants were recruited in person, and data on demographics, LUTS burden, known urologic diagnoses, and bathroom access were collected. Symptoms were characterized using established IPSS and UDI-6 thresholds, indicating clinically significant distress. Analyses used descriptive statistics with 95% confidence intervals and Fisher's exact tests for selected gender comparisons.

Of 47 participants (median age 56; 77% M), 75% had a high LUTS burden based on IPSS or UDI-6. High LUTS burden affected 72% of men and 82% of women. Notably, 83% of those with high symptoms had no prior LUTS or BPH diagnosis. Symptoms suggestive of urgency-predominant LUTS were reported by 32% of respondents, and 41% of UDI-6 respondents reported stress urinary incontinence. Among those with high LUTS burden, bathroom access was often restricted, including limitations to daytime hours or reliance on outdoor urination.

This exploratory study suggests a substantial burden of largely undiagnosed LUTS among PEH in Miami, associated with inadequate restroom access. These preliminary findings underscore the need for larger studies and targeted health interventions to integrate urologic assessment and reliable restroom access into services for this vulnerable population.