title: The relationship between cerebral white matter hyperintensities and lower urinary tract function in a population based, geriatric cohort.
abstract: BACKGROUND
  White matter hyperintensities (WHM) in cerebral MRI-scan have been suspected to be involved in the pathogenesis for geriatric LUTS. Aim of this study was to investigate this association in a geriatric cohort.
  
  
  METHODS
  The VITA-study is a prospective, population-based study initiated 2000/2001. All inhabitants of a well-defined area in Vienna aged 75 years were recruited and underwent detailed regular visits including cerebral MRI-scans. Subcortical and periventricular WMHs were classified according to the Fazekas-classification. In 2010, all subjects alive were contacted to complete the Bristol LUTS questionnaire.
  
  
  RESULTS
  Two hundred seventeen participants (75 men, 142 women), all 85 years old, entered this analysis. Urgency, frequency, and nocturia was present in 39 (50.7%), 53 (52%), and 55 (73.3%) men and 79 (55.6%), 81 (78.2%), and 68 (47.9%) women, respectively. OAB symptoms were seen in 55% of women and 50% of men. At baseline, WMH were present in 68.2% and this percentage increased to 85.7% at the most recent follow-up. Several symptoms were more prevalent in participants without WMH as compared to those with WMH, (urgency: 71% vs. 53%, P=0.06, nocturia: 77% vs. 53%, P=0.01: OAB-symptoms: 71% vs. 51%, P=0.05. Only frequency was more prevalent in participants with WMH (77% vs. 68%, P=0.27). In general, sub-categorization into periventricular and subcortical WMH confirmed these data. Furthermore the amount of WMH-burden did not correlate to LUT dysfunction.
  
  
  CONCLUSIONS
  This study failed to demonstrate a clear association between several aspects of LUTS and WMH in a rather healthy, population-based 85-year-old cohort.
authors.affiliation: Department of Urology and Andrology, Donauspital, Vienna, Austria.
authors.forename: Clemens
authors.initials: C
authors.lastname: Wehrberger
authors.forename: Susanne
authors.initials: S
authors.lastname: Jungwirth
authors.forename: Peter
authors.initials: P
authors.lastname: Fischer
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Tragl
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Krampla
authors.forename: Wehrberger
authors.initials: W
authors.lastname: Marlies
authors.forename: Stephan
authors.initials: S
authors.lastname: Madersbacher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology; D001921:Brain / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012727:Sex Characteristics
keywords: LUTS; VITA; WMH; geriatric; over active bladder; white matter hyperintensities