title: Health-related quality of life associated with lower urinary tract symptoms in four countries.
abstract: OBJECTIVE
  To describe health-related quality of life (HRQL) associated with lower urinary tract symptoms (LUTS) assessed by validated questionnaires in four countries.
  
  
  METHODS
  More than 6000 men, recruited by using community- or population-based sampling in four countries, completed questionnaires soliciting information about urinary symptom frequency, bother, degree of interference with daily activities, and other measures of HRQL.
  
  
  RESULTS
  In all countries, disease-specific HRQL worsened with increasing age. Adjusting for age, most disease-specific HRQL measures were significantly worse with increasing symptom severity. The correlation between symptoms and HRQL was strongest in countries with higher prevalence of symptoms, such as Japan or the United States, and less pronounced in countries with lower prevalence (France, Scotland), possibly reflecting the lower variability in scores.
  
  
  CONCLUSIONS
  HRQL measures are worse in older men, and increased urinary symptom severity is associated with worse disease-specific HRQL in all countries, despite potential cross-cultural differences in disease prevalence, medication use, perceptions, or willingness to report symptoms or worse HRQL. This cross-cultural consistency suggests that an assessment of symptom bother or interference with daily activities may be useful in patient evaluation.
authors.affiliation: Department of Epidemiology, Merck Research Laboratories, West Point, Pennsylvania, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Girman
authors.forename: S J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: T
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: F
authors.initials: F
authors.lastname: Richard
authors.forename: W M
authors.initials: WM
authors.lastname: Garraway
authors.forename: P P
authors.initials: PP
authors.lastname: Sagnier
authors.forename: H A
authors.initials: HA
authors.lastname: Guess
authors.forename: T
authors.initials: T
authors.lastname: Rhodes
authors.forename: P
authors.initials: P
authors.lastname: Boyle
authors.forename: M M
authors.initials: MM
authors.lastname: Lieber
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005602:France; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000175:diagnosis*; D011788:Quality of Life; D012606:Scotland; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States