Engström Gabriella, Walker-Engström Marie-Louise, Henningsohn Lars, Lööf Lars, Leppert Jerzy
Uppsala University, Department of Public Health and Caring Sciences, Uppsala Science Park, Sweden.
Fam Pract. 2004 Dec;21(6):617-22. doi: 10.1093/fampra/cmh607. Epub 2004 Oct 1.
Lower urinary tract symptoms (LUTS) are a common and costly public health issue. The prevalence varies greatly in published reports. The distress caused by each symptom is important to assess the primary care required before therapeutic decisions or a referral to an urologist are made.
LUTS are highly prevalent in men, but less is known regarding the distress caused by each symptom. The aim of this study was to examine symptom severity and different levels of distress using the Danish Prostatic Symptom Score (DAN-PSS) questionnaire in men affected by symptoms from the lower urinary tract.
The study included all men aged 41-81 years (n=504) that, 12 months earlier in a population-based survey, had reported stress incontinence, urgency or post-micturition dribbling in a postal questionnaire. The DAN-PSS questionnaire was used to measure severity and distress from LUTS.
In total, 311 (80%) of the 387 responders who reported at least one symptom experienced some level of distress. The most distressing symptom overall was urinary incontinence. Nine of 10 men with storage symptoms (stress, urge and 'other' urinary incontinence) reported distress even if the symptom occurred only seldom. Moreover, two-thirds of the men with the most frequent symptom, post-micturition dribbling, characterized their symptom as moderate or severe; the most distressing voiding symptom was weak stream. In general, LUTS were well tolerated.
Urge incontinence was the most distressing LUTS even when occurring only seldom. The DAN-PSS questionnaire may be a potentially useful tool for health professionals to identify patients with pronounced distress from LUTS to offer therapeutic and nursing care on the relevant level.
下尿路症状（LUTS）是一个常见且代价高昂的公共卫生问题。已发表报告中的患病率差异很大。在做出治疗决策或转诊给泌尿科医生之前，评估每种症状所引起的困扰对于确定所需的初级护理很重要。
LUTS在男性中非常普遍，但对于每种症状所引起的困扰了解较少。本研究的目的是使用丹麦前列腺症状评分（DAN-PSS）问卷，对受下尿路症状影响的男性的症状严重程度和不同程度的困扰进行检查。
该研究纳入了所有年龄在41-81岁的男性（n=504），这些男性在12个月前的一项基于人群的调查中，通过邮寄问卷报告了压力性尿失禁、尿急或排尿后滴沥。DAN-PSS问卷用于测量LUTS的严重程度和困扰程度。
在报告至少一种症状的387名应答者中，共有311名（80%）经历了某种程度的困扰。总体而言，最令人困扰的症状是尿失禁。10名有储尿症状（压力性、急迫性和“其他”尿失禁）的男性中有9名报告了困扰，即使症状很少出现。此外，有最常见症状——排尿后滴沥的男性中有三分之二将其症状描述为中度或重度；最令人困扰的排尿症状是尿流无力。一般来说，LUTS的耐受性良好。
即使很少出现，急迫性尿失禁也是最令人困扰的LUTS。DAN-PSS问卷可能是卫生专业人员识别因LUTS而有明显困扰的患者的潜在有用工具，以便在相关层面提供治疗和护理。
