Prevalence of distress and symptom severity from the lower urinary tract in men: a population-based study with the DAN-PSS questionnaire.
BACKGROUND
Lower urinary tract symptoms (LUTS) are a common and costly public health issue. The prevalence varies greatly in published reports. The distress caused by each symptom is important to assess the primary care required before therapeutic decisions or a referral to an urologist are made.


OBJECTIVE
LUTS are highly prevalent in men, but less is known regarding the distress caused by each symptom. The aim of this study was to examine symptom severity and different levels of distress using the Danish Prostatic Symptom Score (DAN-PSS) questionnaire in men affected by symptoms from the lower urinary tract.


METHODS
The study included all men aged 41-81 years (n=504) that, 12 months earlier in a population-based survey, had reported stress incontinence, urgency or post-micturition dribbling in a postal questionnaire. The DAN-PSS questionnaire was used to measure severity and distress from LUTS.


RESULTS
In total, 311 (80%) of the 387 responders who reported at least one symptom experienced some level of distress. The most distressing symptom overall was urinary incontinence. Nine of 10 men with storage symptoms (stress, urge and 'other' urinary incontinence) reported distress even if the symptom occurred only seldom. Moreover, two-thirds of the men with the most frequent symptom, post-micturition dribbling, characterized their symptom as moderate or severe; the most distressing voiding symptom was weak stream. In general, LUTS were well tolerated.


CONCLUSIONS
Urge incontinence was the most distressing LUTS even when occurring only seldom. The DAN-PSS questionnaire may be a potentially useful tool for health professionals to identify patients with pronounced distress from LUTS to offer therapeutic and nursing care on the relevant level.
Engström
Gabriella
G
Uppsala University, Department of Public Health and Caring Sciences, Uppsala Science Park, Sweden. gabriella.engstrom@mdh.se
Walker-Engström
Marie-Louise
ML
Henningsohn
Lars
L
Lööf
Lars
L
Leppert
Jerzy
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000503:physiopathology; D014551:Urinary Tract / Q000503:physiopathology; D014555:Urination Disorders / Q000145:classification / Q000453:epidemiology / Q000503:physiopathology*