title: Self-assessed health, sadness and happiness in relation to the total burden of symptoms from the lower urinary tract.
abstract: OBJECTIVE
  To evaluate the effect of lower urinary tract symptoms (LUTS) on self-assessed health, sadness and happiness of men.
  
  
  METHODS
  The study included 504 men (aged 40-80 years) in the rural community of Surahammar, Sweden, who a year earlier had reported stress incontinence, urgency or postvoid dribbling in answer to a postal questionnaire, and 504 age-matched control men from the same community. The occurrence of 12 specific LUTS was rated using the Danish Prostatic Symptom Score. Health, sadness and happiness were measured by three questions from the Medical Outcomes Study Short-Form 36 health survey questionnaire.
  
  
  RESULTS
  Completed questionnaires were returned by 74.2% of men (748/1008). A low score for health was reported by 34% of men with one to four LUTS, by 67% with five to eight, and by 75% with nine or more LUTS. The total LUTS burden correlated with lower scores for happiness and with higher scores for sadness. For each of the 12 specific LUTS, men with the symptom had lower scores for health and happiness, and higher scores for sadness, than men without the symptom. Comparing men with the symptom of 'other incontinence' to men with no 'other incontinence', the relative risk (95% confidence interval) of impaired health was 2.2 (1.8-2.8), while that of a high score for happiness was 0.5 (0.3-0.7) and that of greater sadness was 2.3 (1.7-3.3). Social status, marital status, education, smoking, physical activity and urinary tract infection all affected the impact of LUTS.
  
  
  CONCLUSIONS
  The total burden of LUTS is related to self-assessed health, sadness and happiness.
authors.affiliation: Uppsala University, Department of Public Health and Caring Sciences, Uppsala Science Park, Uppsala, Sweden. gabriella.engstrom@mdh.se
authors.forename: Gabriella
authors.initials: G
authors.lastname: Engström
authors.forename: Lars
authors.initials: L
authors.lastname: Henningsohn
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
authors.forename: Jerzy
authors.initials: J
authors.lastname: Leppert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017281:Cost of Illness; D004644:Emotions; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000523:psychology*; D012647:Self-Assessment; D013548:Sweden; D014550:Urinary Incontinence, Stress / Q000523:psychology*; D016055:Urinary Retention / Q000523:psychology*