Vasudevan Vishrudh, Fernandez Golena Moncaleano, Dunn Rodney L, Miner Martin, Roehrborn Claus, Rosen Raymond, Seftel Allen, Spino Cathie, Wei John T, Sarma Aruna V
College of Medicine, Central Michigan University, Mount Pleasant, Michigan, USA.
Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.
Neurourol Urodyn. 2025 Aug;44(6):1325-1331. doi: 10.1002/nau.70090. Epub 2025 Jun 2.
To assess the impact of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH) and other urinary conditions on quality of life (QoL), in comparison to other comorbidities, after adjusting for lifestyle and demographic factors.
The BPH Registry and Patient Survey is a multicenter, longitudinal, observational database of management practices and patient outcomes in a population of 6924 patients with BPH in the USA, managed with watchful waiting or pharmacotherapy. QoL was assessed using the Medical Outcomes Study-Short Form 12 physical (SF12 PCS) and mental health (SF12 MCS) component scores. The following urinary conditions were evaluated: lower urinary tract symptoms (LUTS) assessed using the International Prostate Symptom Score (IPSS), physician diagnosed urinary incontinence (UI), overactive bladder (OAB) and urinary tract infection (UTI). Associations between QoL and urinary conditions and other co-morbidities adjusted for demographic/lifestyle factors were estimated in 3818 men with complete data using linear regression models.
Approximately 21.1% of the population reported having at least one urinary condition; however, prevalence of specific urinary conditions was less than other co-morbidities. After adjusting for age, marital status, education, income, employment, alcohol use and smoking status, severe LUTS (IPSS ≥ 20) and UI were associated with a 3.9- and 2.9-point decrease in the SF12 PCS, respectively. These associations were similar to those observed with arthritis and depression, and more significant than the PCS reductions associated with cardiovascular disease (CVD), cancer, and diabetes. Urinary conditions also led to greater reductions in the SF12 MCS compared to other comorbidities, with only depression showing a greater impact on MCS scores.
These results highlight that the impact of urinary conditions, particularly LUTS and UI, on QoL is similar to, if not more substantial than, that of other major chronic diseases. These conditions affect not only the physical component of QoL but also significantly influence the mental domains.
在调整生活方式和人口统计学因素后，评估与良性前列腺增生（BPH）及其他泌尿系统疾病相关的下尿路症状（LUTS）对生活质量（QoL）的影响，并与其他合并症进行比较。
BPH注册登记与患者调查是一个多中心、纵向的观察性数据库，记录了美国6924例接受观察等待或药物治疗的BPH患者的管理实践和患者结局。使用医学结局研究简表12的躯体健康（SF12 PCS）和精神健康（SF12 MCS）分量表对生活质量进行评估。评估了以下泌尿系统疾病：使用国际前列腺症状评分（IPSS）评估的下尿路症状（LUTS）、医生诊断的尿失禁（UI）、膀胱过度活动症（OAB）和尿路感染（UTI）。使用线性回归模型，在3818例有完整数据的男性中，估计了调整人口统计学/生活方式因素后生活质量与泌尿系统疾病及其他合并症之间的关联。
约21.1%的人群报告至少有一种泌尿系统疾病；然而，特定泌尿系统疾病的患病率低于其他合并症。在调整年龄、婚姻状况、教育程度、收入、就业、饮酒和吸烟状况后，重度LUTS（IPSS≥20）和UI分别与SF12 PCS降低3.9分和2.9分相关。这些关联与关节炎和抑郁症的关联相似，且比与心血管疾病（CVD）、癌症和糖尿病相关的PCS降低更为显著。与其他合并症相比，泌尿系统疾病导致SF12 MCS降低幅度更大，只有抑郁症对MCS评分的影响更大。
这些结果突出表明，泌尿系统疾病，尤其是LUTS和UI，对生活质量的影响即便不比其他主要慢性病更严重，也与之相似。这些疾病不仅影响生活质量的躯体方面，还对精神领域有显著影响。
