title: Analyzing Why Men Seek Treatment for Lower Urinary Tract Symptoms and Factors Associated With Nonimprovement.
abstract: OBJECTIVE
  To determine the motivating factor for why men seek urologic care and determine persistence of these symptoms and any factors that influence resolution.
  
  
  METHODS
  Men presenting to an outpatient urology clinic with lower urinary tract symptoms (LUTSs) were prospectively evaluated. At each of 2 visits, surveys were administered including the American Urological Association Symptom Index and a chief LUTS complaint (CLC) identification form. On the CLC identification form, symptoms were considered "transient" if only seen at V1 and "persistent" if they were selected at both visits.
  
  
  RESULTS
  Sixty-five percent of the 1240 participants were able to specify a CLC. Among these, nocturia was by far the most common and was found to be persistent in 49% of cases. When comparing the groups of patients who presented with transient verses persistent nocturia, older age (P <.001), diabetes (P = .006), hypertension (P = .033), alpha-blocker use (P = .018), 5-alpha-reductase inhibitor use (P = .008), higher nocturia severity (P <.001), and more severe American Urological Association Symptom Index scores at initial visit (P = .047) were found to be predictors of persistent nocturia.
  
  
  CONCLUSIONS
  Most men with LUTS can identify a predominant CLC. Of these, nocturia is the primary CLC of most men and does not improve in almost 50% of those studied. By improving our identification of a predominant CLC and the patient factors that influence both the development and persistence of urinary symptoms, we may start to better evaluate and hopefully focus treatment on the most bothersome urinary symptom.
authors: Division of Urology, Albany Medical College, Albany, NY; Division of Urology, Albany Stratton Veterans Affairs Hospital, Albany, NY. Electronic address: chuck.welliver@gmail.com.
authors: Charles
authors: C
authors: Welliver
authors: Division of Urology, Southern Illinois University School of Medicine, Springfield, IL.
authors: Randy
authors: R
authors: Sulaver
authors: Division of Urology, NorthShore University Health System, Evanston, IL.
authors: Adam
authors: A
authors: Whittington
authors: Division of Urology, NorthShore University Health System, Evanston, IL.
authors: Brian T
authors: BT
authors: Helfand
authors: Department of Urology, Istanbul Bagcilar Research and Training Hospital, Istanbul, Turkey.
authors: Ömer Onur
authors: ÖO
authors: Çakır
authors: Department of Medical Social Sciences, Northwestern University, Chicago, IL.
authors: James W
authors: JW
authors: Griffith
authors: Division of Urology, Southern Illinois University School of Medicine, Springfield, IL.
authors: Kevin T
authors: KT
authors: McVary
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D015331:Cohort Studies; D018450:Disease Progression; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D053158:Nocturia / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014481:United States; D014563:Urodynamics