Family Practice Advance Access originally published online on October 1, 2004
Family Practice 2004 21(6):617-622; doi:10.1093/fampra/cmh607
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Family Practice Vol. 21, No. 6 © Oxford University Press 2004, all rights reserved.
Prevalence of distress and symptom severity from the lower urinary tract in men: a population-based study with the DAN-PSS questionnaire
a Uppsala University, Department of Public Health and Caring Sciences, Uppsala Science Park, b Centre for Clinical Research, Uppsala University, Central Hospital, Uppsala, c Department of Caring and Public Health Sciences, Mälardalen University, Västerqs, d Clinical Cancer Epidemiology, Department of Oncology-Pathology and e Division of Urology, Centre for Surgical Sciences, Karolinska Institute, Stockholm, Sweden.
Correspondence to Gabriella Engström, Department of Caring Science, Mälardalen University, Box 325, S-63105 Eskilstuna, Sweden; Email: gabriella.engstrom{at}mdh.se
Background. 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.
Objectives. 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.
Methods. 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.
Results. 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.
Conclusion. 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.
Keywords. DAN-PSS, distress, LUTS, population-based, postal questionnaire.