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Family Practice Advance Access published online on October 1, 2004
Family Practice, doi:10.1093/fampra/cmh607
© 2004 by Oxford University Press
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Received May 26, 2004
Accepted July 20, 2004

Article

Prevalence of distress and symptom severity from the lower urinary tract in men: a population-based study with the DAN-PSS questionnaire

Gabriella Engström 1*, Marie-Louise Walker-Engström 2, Lars Henningsohn 3, Lars Lööf 2, and Jerzy Leppert 2

1 Uppsala University, Department of Public Health and Caring Sciences, Uppsala Science Park, Uppsala, Sweden; Department of Caring and Public Health Sciences, Mälardalen University, Västerqs, Sweden
2 Centre for Clinical Research, Uppsala University, Central Hospital, Uppsala, Sweden
3 Clinical Cancer Epidemiology, Department of Oncology-Pathology, Centre for Surgical Sciences, Karolinska Institute, Stockholm, Sweden; Division of Urology, Centre for Surgical Sciences, Karolinska Institute, Stockholm, Sweden

* To whom correspondence should be addressed. E-mail: gabriella.engstrom{at}mdh.se.


  Abstract

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, twothirds 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.
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