Beyond the Lower Urinary Tract: The Association of Urologic and Sexual Symptoms with Common Illnesses

Abstract

Objective-In addition to being prevalent and bothersome, urologic and sexual symptoms may be related to chronic medical illnesses. We investigate the relationship between ten urologic and sexual symptoms and four major illnesses (type II diabetes, cardiac disease, hypertension, and depression).Methods-We analyze data from the Boston Area Community Health (BACH) Survey, a community-based epidemiologic study of urologic symptoms and risk factors. BACH used a twostage stratified cluster sampling design to recruit 5,506 adults aged 30-79 (2,301 men, 3,205 women; 1,770 Black, 1,877 Hispanic, and 1,859 White respondents).Results-In bivariate analyses, most urologic and sexual symptoms are associated with type II diabetes, cardiac disease, hypertension, and depression. However, in multivariate models adjusting for all four illnesses, gender, race/ethnicity, age, alcohol intake, smoking, physical activity, and body mass index there were fewer significant associations. We found that all urologic symptoms were significantly related to at least one illness, with depression increasing the odds of all urologic and sexual symptoms studied.Conclusions-Urinary tract specialists may need to give greater weight to consideration of factors outside the urinary tract that may be contributing to urologic symptoms. It remains unknown whether treatment of medical and psychological illnesses can result in meaningful improvement in urologic symptoms, or conversely, whether urinary tract symptoms can provide valuable insight into an individual's overall health status. Keywords epidemiology; diabetes; hypertension; cardiac disease; depression; lower urinary tract symptoms; painful bladder syndrome; urinary incontinence; prostatitis; overactive bladder; frequency; urgency; nocturia; erectile dysfunction; female sexual dysfunction Corresponding author: Dr. Carol L. Link, New England Research Institutes, 9 Galen Street, Watertown, MA 02472, USA, Telephone: (1) 617-923-7747, Fax: (1) 617-926-8246, clink@neriscience.com. Take-home message Urological and sexual symptoms are significantly associated with depression, and to a lesser extent with cardiac disease, type II diabetes, and hypertension. Providers may need to look beyond the bladder and lower urinary tract to understand and/or treat presenting symptoms.

An examination of the association of abuse (physical, sexual, or emotional) and female sexual dysfunction: results from the Boston Area Community Health Survey

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“…Nocturia is age-related and both genders have a similar prevalence (5)(6)(7). In previous epidemiologic surveys, the prevalence of nocturia ( 2 episodes per night) showed great variation, from 10% (5) to 30% (6,7), depending upon the study population and methodology.…”

“…In previous epidemiologic surveys, the prevalence of nocturia ( 2 episodes per night) showed great variation, from 10% (5) to 30% (6,7), depending upon the study population and methodology. Despite the variations, the reports revealed that nocturia is a non--specifi c, but common urinary symptom.…”