Prevalence and correlations of lower urinary tract symptoms, erectile dysfunction and incontinence in men from a multiethnic Asian population: Results of a regional population-based survey and comparison with industrialized nations.
OBJECTIVE
To determine, in a population-based survey, the prevalence of lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and incontinence in community-dwelling men in multiethnic Malaysia, as currently available Western demographic data might not be applicable in the Asian population.


METHODS
A cross-sectional population-based survey was carried out in the State of Penang, Malaysia, with a target population of men aged > or = 40 years. Using a multistage study design, random systematic sampling was used to represent the target population, who were weighted based on ethnicity and rural-urban ratios so as to represent the general population distribution. Trained field-workers conducted direct interviews and administered the American Urological Association Symptom Index (AUA-SI), the International Index of Erectile Function (IIEF-5) questionnaire and questions on incontinence based on the International Continence Society 2002 definition.


RESULTS
In all, 418 men aged > or = 40 years were interviewed, of whom 353 completed the AUA-SI questionnaire (84.5% response rate). The prevalence of mild, moderate and severe LUTS was 80.6%, 6% and 0.3%, respectively. The prevalent symptoms were frequency and nocturia. There was moderate and severe ED in 45.9% of men, whereas incontinence was reported by 8.2%. The AUA-SI correlated strongly with age (R = 0.291, P < 0.001), IIEF-5 (R = - 0.265, P < 0.001) and diabetes mellitus.


CONCLUSIONS
The prevalence and severity of LUTS, ED and incontinence increased with age in this multiethnic Asian population, in which ED correlated strongly with LUTS. Compared to the Western population, the prevalence of LUTS was significantly lower, while the prevalence of ED and incontinence were comparable.
Mariappan
Paramananthan
P
Department of Urology, Western General Hospital, Edinburgh, UK. param.mariappan@nhs.net
Chong
Wooi Loong
WL
D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D003430:Cross-Sectional Studies; D019049:Developed Countries; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000208:ethnology; D006306:Health Surveys; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D053448:Prostatism / Q000453:epidemiology* / Q000208:ethnology; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000208:ethnology