title: Prevalence, severity, and symptom bother of lower urinary tract symptoms among men in the EPIC study: impact of overactive bladder.
abstract: BACKGROUND
  Lower urinary tract symptoms (LUTS) are prevalent among men.
  
  
  OBJECTIVE
  To describe the prevalence, severity, and symptom bother of LUTS in all men and men with overactive bladder (OAB) symptoms in the EPIC study.
  
  
  METHODS
  A secondary analysis of data from EPIC, a multinational population-based survey of 19,165 adults, was performed. Current International Continence Society definitions were used for individual LUTS and OAB; OAB cases were defined as men reporting urgency.
  
  
  METHODS
  Participants were asked about the presence of individual LUTS and associated symptom bother. LUTS severity was measured using the International Prostate Symptom Score (IPSS).
  
  
  CONCLUSIONS
  There was substantial overlap of storage, voiding, and postmicturition symptoms among all men (n=7210) and in men with OAB symptoms (n=502); men with OAB symptoms were more likely to experience multiple LUTS subtypes. Among both populations, nocturia was the most commonly reported symptom, except for urgency (the hallmark symptom) among men with OAB symptoms; terminal dribble and sensation of incomplete emptying were the most common voiding and postmicturition symptoms. The prevalence of all LUTS increased with age among the general population; only storage LUTS increased with age among men with OAB symptoms. Number of LUTS and mean IPSS increased with age in both populations but were higher among men with OAB symptoms at all ages; the proportion reporting moderate-severe LUTS was higher than the general population (30% vs 6%). The proportion of men with OAB symptoms reporting symptom bother increased with urgency severity and severity and number of LUTS. LUTS severity may have been underestimated by the IPSS, which does not assess incontinence.
  
  
  CONCLUSIONS
  Men with LUTS commonly experience coexisting storage, voiding, and postmicturition symptoms, emphasizing the need for comprehensive urologic assessments. Men with OAB symptoms reported more LUTS and greater severity than the general population. Symptom bother was related to number of LUTS and urgency severity.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599, USA. dirwin@email.unc.edu
authors.forename: Debra E
authors.initials: DE
authors.lastname: Irwin
authors.forename: Ian
authors.initials: I
authors.lastname: Milsom
authors.forename: Zoe
authors.initials: Z
authors.lastname: Kopp
authors.forename: Paul
authors.initials: P
authors.lastname: Abrams
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
authors.forename: Sender
authors.initials: S
authors.lastname: Herschorn
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012720:Severity of Illness Index; D053201:Urinary Bladder, Overactive / Q000453:epidemiology*; D014555:Urination Disorders / Q000145:classification* / Q000453:epidemiology*; D014570:Urologic Diseases / Q000453:epidemiology