title: Seasonal alterations in nocturia and other storage symptoms in three Japanese communities.
abstract: OBJECTIVE
  To conduct a community-based questionnaire study to uncover the relationship between climates and lower urinary tract symptoms.
  
  
  METHODS
  A total of 6000 residents aged 41 to 70 years were randomly selected in three Japanese towns (Tobetsu in a subartic zone, Kumiyama in a temperate zone, and Sashiki in a subtropical zone). A self-administered questionnaire, which included the International Prostate Symptom Score, and overall incontinence score from the International Consultation on Incontinence Questionnaire Short Form was mailed to one half of the targets in the summer and the remaining one half in the winter. A logistic regression model was used for the main statistical analysis, with P <0.05 considered significant.
  
  
  RESULTS
  A total of 1124 responses (37.5%) to the summer study and 1156 (38.5%) to the winter study were available for analysis. Three storage symptoms (frequency, urgency, and nocturia) demonstrated statistically significant differences between the two seasons. Multivariate logistic regression analysis revealed that winter was an independent risk factor of frequency (score of 1 or more, P <0.0001, odds ratio [OR] 1.47; and score of 2 or more, P = 0.0089, OR 1.30), urgency (score of 1 or more, P = 0.0022, OR 1.38), and nighttime voiding (score of 2 or more, P = 0.0012, OR 1.40). This tendency was marked in the subtropical zone but was not observed in the subartic zone.
  
  
  CONCLUSIONS
  These findings suggest that epidemiologic studies focusing on the prevalence of lower urinary tract symptoms should take into consideration the impact of seasonal changes, especially in communities in warmer zones.
authors.affiliation: Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan. ky7527@kuhp.kyoto-u.ac.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kamoto
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Oshiro
authors.forename: Naoko
authors.initials: N
authors.lastname: Kinukawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000175:diagnosis / Q000453:epidemiology*; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D012621:Seasons; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000175:diagnosis / Q000453:epidemiology*; D014555:Urination Disorders / Q000175:diagnosis / Q000453:epidemiology