title: Effect of sexually transmitted infections, lifetime sexual partner count, and recreational drug use on lower urinary tract symptoms in men who have sex with men.
abstract: OBJECTIVE
  To investigate the relationship of lower urinary tract symptoms (LUTS) to urinary tract infection, prostatitis, sexually transmitted infection, lifetime sexual partner count, and recreational drug use in a population of men who have sex with men. LUTS in men are a source of considerable morbidity, distress, and medical expense.
  
  
  METHODS
  We conducted a cross-sectional, Internet-based survey of urinary quality-of-life outcomes in men who have sex with men. The main outcome was the International Prostate Symptom Score (IPSS), classified as none/mild (IPSS 0-7), moderate/severe (IPSS 8-35), or severe (IPSS 20-35). The participants were also asked whether they ever sought medical attention for urinary problems.
  
  
  RESULTS
  The survey web site was accessed by 2783 men, of whom 2348 (84.3%) completed the questionnaire. The median age was 39 years (range 18-81). Age, depression, human immunodeficiency virus infection, gonorrhea, syphilis, prostatitis, and prescription drug abuse were all associated with LUTS. Men who sought medical attention for LUTS were more likely to report older age, diabetes, depression, gonorrhea, urinary tract infection history, and prostatitis.
  
  
  CONCLUSIONS
  Specific infectious conditions of the urinary tract and depressive symptoms are independent predictors of LUTS in men who have sex with men. Although LUTS are often multifactorial, a common unifying explanation for our finding could be the effects of local and systemic inflammation on the lower urinary tract.
authors.affiliation: Department of Urology, University of California, San Francisco, School of Medicine, San Francisco, California 94143, USA. bbreyer@urology.ucsf.edu
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Van Den Eeden
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Erickson
authors.forename: Alan W
authors.initials: AW
authors.lastname: Shindel
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001294:Attitude to Health; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011472:Prostatitis / Q000175:diagnosis / Q000453:epidemiology; D011788:Quality of Life; D018570:Risk Assessment; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000503:physiopathology; D014555:Urination Disorders / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult