IntroductionFew population-based data are available evaluating the prevalence of lower urinary tract symptoms (LUTS) in Asia. The objective of our study was to determine LUTS prevalence in China, Taiwan, and South Korea using International Continence Society (ICS) 2002 criteria.MethodsAn Internet-based self-administered survey among individuals aged at least 40 years with the ability to use a computer and to read the local language. Survey questions included ICS symptom definitions and the international prostate symptom score (IPSS). Data analysis was based on descriptive statistics and post hoc significance testing.ResultsThere were 8284 participants, of whom 51% were women and 34% were aged at least 60 years. LUTS prevalence was slightly higher in men than women (62.8% vs. 59.6%; p = 0.004), increasing significantly with age (p = 0.001). All three ICS symptom groups (voiding, storage, and post-micturition) were present in 35% of individuals with LUTS. Symptoms with the highest overall prevalence were nocturia, frequency, incomplete emptying, and terminal dribble. The most bothersome symptoms were terminal dribble, nocturia, and urgency. According to IPSS scores, 87% of participants had at least mild symptoms; 43% of those aged over 60 years had moderate/severe symptoms. The percentage of participants with any LUTS who had visited healthcare professionals because of urinary symptoms was 26%, rising to 45% amongst individuals with all three symptom groups (p = 0.001 vs. other ICS symptom groups).ConclusionsLUTS are highly prevalent in men and women aged at least 40 years who participated in this study in China, Taiwan, and South Korea and increases with increasing age. A minority of individuals with LUTS seek healthcare and our results suggest an increased patient awareness of LUTS is required.FundingAstellas Pharma Singapore Pte. Ltd.Trial registrationClinicalTrials.gov identifier, NCT02618421.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-017-0577-9) contains supplementary material, which is available to authorized users.

Objective: The aim of the present study was to determine the prevalence of overactive bladder (OAB) in individuals aged ≥40 years in China, Taiwan, and South Korea.Methods: The present cross-sectional population-representative Internet-based study investigated OAB symptoms in men and women aged ≥40 years using the overactive bladder symptom score. Additional instruments included the International Index of Erectile Function (men only) and the Sexual Quality of Life -Female (women only) questionnaires, as well as Patient Perception of Bladder Condition (PPBC).Results: In all, 8284 individuals participated in the study. The prevalence of OAB was 20.8% overall (women 22.1%, men 19.5%) and increased significantly with age, from 10.8% in those aged 40-44 years to 27.9% in those aged >60 years (P = .001). The presence of comorbid conditions (e.g. neurological disease, diabetes) was associated with a significantly increased prevalence of OAB.Increasing symptom severity was associated with significantly worsening patient perception of bladder condition responses. Just under half (48%) of those with no OAB had no lower urinary tract symptoms (LUTS), whereas 88% of those with severe symptoms had all 3 LUTS (International Continence Society definition) symptom categories (voiding, post-micturition, and storage symptoms). Of those without OAB, 10% reported visiting healthcare professionals for urinary symptoms, compared with 64% of those with severe OAB symptoms (P = .001). Increased symptom severity was significantly associated with lower sexual quality of life in both men and women.Conclusions: OAB symptoms were found to affect 1 in 5 individuals aged ≥40 years in China, Taiwan, and South Korea, becoming more common with increasing age. The results suggest that many more individuals with OAB could benefit by consulting healthcare professionals. K E Y W O R D SChina, overactive bladder, prevalence, Republic of Korea, Taiwan

Background: Men with lower urinary tract symptoms (LUTS) treated with a-blockers (eg, tamsulosin) may experience overactive bladder (OAB) symptoms and receive add-on antimuscarinics. Mirabegron (a b3-adrenoreceptor agonist) is an alternative add-on therapy. Objective: To evaluate the efficacy of mirabegron versus placebo in men with OAB symptoms receiving tamsulosin for LUTS. Design, setting, and participants: Japanese and Korean men with OAB treated with tamsulosin for LUTS (January 2016-July 2017). Intervention: Single-blind, 4-wk screening: tamsulosin plus placebo orally once daily; double-blind, 12-wk treatment: patients randomized (n = 568) to mirabegron 50 mg or placebo, as add-on to tamsulosin. Outcome measurements and statistical analysis: Primary endpoint: baseline to end of treatment (EoT) change in the mean number of micturitions/24 h, based on a 3-d voiding diary. Secondary endpoints: change in other diary variables and patient-reported outcomes from baseline to EoT. The primary endpoint was analyzed by analysis of covariance, including treatment group and region as fixed factors and baseline as a covariate. Results and limitations: Mirabegron add-on therapy was superior to placebo in improving the primary endpoint (adjusted mean difference [95% confidence interval] vs placebo-0.52 [-0.82 to-0.21]) and secondary endpoints, including mean volume voided/micturition (12.08 [6.33-17.84]), OAB symptom score (-0.65 [-1.04 to-0.26]), International Prostate Symptom Score total (-1.19 [-1.94 to-0.44]), storage (-0.78 [-1.13 to-0.43]), quality of life scores (-0.29 [-0.51 to-0.07]), OAB symptom bother (-4.52 [-6.91 to-2.13]), and total health-related quality of life (2.79 [1.13 to 4.44]). Differences, compared with placebo, in urgency, urgency urinary incontinence, and nocturia were not statistically significant. Mirabegron was well tolerated, with no major safety concerns. Limitations included a lack of antimuscarinic comparison. Conclusions: The mirabegron add-on therapy to tamsulosin for 12 wk in men with LUTS and OAB symptoms demonstrated superior efficacy to placebo and was well tolerated. Patient summary: We looked at the efficacy and safety of mirabegron compared with placebo in men being treated with tamsulosin but who still had overactive bladder symptoms. Mirabegron improved overactive bladder symptoms and patient-reported outcomes compared with placebo, and was well tolerated.

PurposeLower urinary tract symptoms (LUTS) can be distressing and socially isolating, and the economic impact can be substantial. Further data to characterize the epidemiology and effects of LUTS in South Korea would be beneficial.Materials and MethodsIn an international, internet-based survey, the prevalence and impact of LUTS was evaluated in adults aged ≥40 years. Questions related to International Continence Society (ICS) symptom definitions and the bother associated with each symptom. The international prostate symptom score (IPSS) and the overactive bladder symptom score (OABSS) were assessed.ResultsOf the 2,080 participants from South Korea, 1,090 (52.4%) were women and 740 (35.6%) were aged ≥60 years. The prevalence of LUTS according to ICS criteria was 68.2% (men, 70.6%; women, 66.0%). LUTS prevalence increased significantly with age (p=0.01 in men and women). Storage symptoms only were reported in 16.2% of men and 30.5% of women, making this the most common ICS symptom group overall. Individual symptoms with the highest prevalence in the overall population were nocturia, frequency, and weak stream (36%, 30%, and 29%, respectively). IPSS results showed that 40.1% of participants had at least moderate symptoms. The prevalence of OABSS-defined overactive bladder was 19.7% (men, 19.5%; women, 19.9%). Fourteen percent of individuals with any LUTS visited healthcare professionals regarding urinary symptoms.ConclusionsLUTS affect the majority of adults aged ≥40 years in South Korea. The low percentage of individuals with LUTS consulting healthcare professionals regarding urinary symptoms indicates a need to improve rates of diagnosis and treatment.

BackgroundLower urinary tract symptoms (LUTS) and overactive bladder (OAB) symptoms have a substantial effect on quality of life (QoL). We report QoL and mental health results from a LUTS prevalence study in three Asian countries.MethodsA cross-sectional, population-representative, internet-based study among individuals aged ≥40 years in China, Taiwan and South Korea. Instruments included: Overactive Bladder Symptom Score (OABSS); International Prostate Symptom Score (IPSS); other International Continence Society (ICS) symptom questions; health-related QoL 12-item short-form (HRQoL-SF12v2); Work Limitations Questionnaire (WLQ); Hospital Anxiety and Depression Scale (HADS). Presence of LUTS was determined according to ICS criteria, with three symptom groups (storage, voiding and post-micturition). Post-stratification weighting matched the age and sex population distribution per country. Initial data analyses were based on descriptive statistics. Significance testing undertaken post hoc included: independent-samples t-test (differences in HRQoL between sexes and between individuals with/without LUTS; relationship between HRQoL score and OABSS; differences in HADS anxiety and depression scores between individuals with/without LUTS; association between HADS anxiety/depression scores and OABSS), chi-square test (association between LUTS prevalence and workplace productivity) and analysis of variance (differences in HRQoL score and in HADS anxiety/depression scores between individuals with different symptom groups, association between HADS anxiety/depression scores and IPSS).ResultsIn total, 8284 participants were included. HRQoL scores were significantly worse (p < 0.001) among individuals with versus without LUTS (ICS criteria): mean physical health domain scores were 61.1 (standard deviation [SD], 20.1) and 76.7 (17.0), respectively; corresponding mental health domain scores were 34.8 (12.7) and 43.7 (10.7). Workplace productivity was best among individuals without LUTS (difficulties reported by 2–3% of individuals), and worst in those with all three ICS symptom groups (difficulties reported by 29–38% of individuals; p = 0.001). Mean HADS scores showed significantly worse (p < 0.001) levels of anxiety and depression among individuals with versus without LUTS: anxiety, 6.5 (SD, 3.7) and 4.0 (3.3); corresponding mean depression scores were 6.8 (4.3) and 4.2 (3.6). Increasing OAB severity was also associated with decreasing HRQoL physical and mental health scores.ConclusionLUTS and increasing OAB severity are both associated with impaired QoL, reduced workplace productivity, and increased tendency towards anxiety and depression. These results highlight the need to ensure that individuals with LUTS receive appropriate, effective treatment.Trial registrationClinicalTrials.gov identifier: NCT02618421, registered 26 November 2015 (retrospectively registered).