title: Is there seasonal variation in symptom severity, uroflowmetry and frequency-volume chart parameters in men with lower urinary tract symptoms?
abstract: OBJECTIVE
  There is a widely held perception that lower urinary tract symptoms may be exacerbated by cold weather. In this study, we examine the effect of seasonal variation in ambient temperatures on frequency-volume chart derivatives, symptom severity scores and uroflowmetry parameters in men with lower urinary tract symptom.
  
  
  METHODS
  Between January 2000 and April 2004, men presenting with lower urinary tract symptom were prospectively recruited and assessed in Edinburgh, UK (55°52'N) with maritime temperate climates (Köppen classification Cfb). Local monthly temperatures were extracted from national meteorological records. Patients completed the International Prostate Symptom Score and 3-day frequency volume chart before undergoing free uroflowmetry with post-micturition volume measurement. Exclusion criteria were previous bladder outflow surgery and anti-cholinergic medication.
  
  
  RESULTS
  Data on 296 patients were suitable for analysis. Mean age was 62.3 years (range, 26-90). Over the period of study, the coldest month was January (mean = 4.7℃) and the warmest month was August (mean = 15.8℃). There was no significant variation in either International Prostate Symptom Score symptom scores by season (p > 0.05) or any frequency-volume chart parameters, with the exception on an increase in median actual nightly voids over the summer months (p = 0.021). There was no significant correlation between maximal flow rate and post-micturition residual volumes and mean monthly temperatures (p > 0.05).
  
  
  CONCLUSIONS
  Seasonal variation in nocturia, but not other frequency-volume parameters, symptom severity or uroflowmetry parameters, is significant in men with lower urinary tract symptom. Future work should consider the impact of seasonal variation in lower urinary tract symptoms in both sexes across a wider range of climates.
authors.affiliation: Clinical Research Fellow, Department of Epidemiology & Biostatistics, Imperial College, UK.
authors.forename: Rufus
authors.initials: R
authors.lastname: Cartwright
authors.affiliation: Consultant Urological Surgeon, Department of Urology, Western General Hospital, UK.
authors.forename: Paramananthan
authors.initials: P
authors.lastname: Mariappan
authors.affiliation: Consultant Urological Surgeon, Department of Urology, Royal Bournemouth Hospital, UK.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Turner
authors.affiliation: Consultant Urological Surgeon, Department of Urology, Royal Bournemouth Hospital, UK.
authors.forename: Laurence H
authors.initials: LH
authors.lastname: Stewart
authors.affiliation: Honorary Speciality Registar in Urology, Department of Urology, Gartnavel General Hospital, UK p.rajan@beatson.gla.ac.uk.
authors.forename: Prabhakar
authors.initials: P
authors.lastname: Rajan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003080:Cold Temperature / Q000009:adverse effects; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000503:physiopathology; D012212:Rheology; D012621:Seasons; D012720:Severity of Illness Index; D014554:Urination; D014556:Urine; D014563:Urodynamics
keywords: IPSS; Seasonal variation; frequency volume charts; lower urinary tract symptoms; temperature variation; uroflowmetry