Overlap Of Voiding Symptoms, Storage Symptoms And Pain In Men And Women

Main Category: Urology / Nephrology
Article Date: 20 Jan 2008 - 0:00 PDT

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UroToday.com- Overactive bladder, LUTS (lower urinary tract symptoms), bladder pain syndrome/interstitial cystitis, and chronic prostatitis/chronic pelvic pain syndrome all fall under the rubric of symptom driven diagnoses. No objective marker exists for any of these conditions and all are diagnoses of exclusion.

Clemens and colleagues from Chicago and Portland sampled 5000 men and 5000 women in the Kaiser Permanente Northwest Division with a questionnaire inquiring about urological symptoms. The response rate was 35%. They limited their analysis to individuals with at least 1 urological symptom in order to quantify the degree of overlap of the various symptom types in those who were symptomatic.

Their findings are very interesting. Of those with at least one urologic symptom, nocturia was present in 90%, followed by urgency, frequency, and pain at 30-40% each. Slow stream, incomplete emptying, and intermittence were in the 10-15% range. The degree of symptom overlap was dramatic. Of individuals with storage or voiding symptoms, 34% of men and 43% of women also had pain symptoms. Of those with pain, 90% of men and 94% of women also had voiding or storage symptoms. Frequency, urgency, and any storage symptoms were statistically more common in women than in men, while a slow stream was more common in men than women.

While not necessarily showing that the 4 syndromes themselves overlap, the study does illustrate the problems inherent when one is studying a predominantly symptom-based disorder especially from an epidemiologic viewpoint.

Clemens JQ, Markossian TW, Meenan RT, O'Keeffe Rosetti MC, Calhoun EA

J Urol. 178(4):1354-1358, October 2007.
doi:10.1016/j.juro.2007.05.157

Reported by UroToday.com Contributing Editor Philip Hanno M.D

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