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Symptom prevalence, bother, and treatment satisfaction in men with lower urinary tract symptoms in Southeast Asia: a multinational, cross-sectional survey

  • Ho LY 1,
  • Chu PS 2,
  • Consigliere DT 3,
  • Zainuddin ZM 4,
  • Bolong D 5,
  • Chan CK 6,
  • Eng M 7,
  • Huynh DN 8,
  • Kochakarn W 9,
  • Lapitan MCM 10,
  • Le DK 11,
  • Le QD 7,
  • Lee F 13,
  • Lojanapiwat B 14,
  • Nguyen BN 15,
  • Ong TA 16,
  • Reyes BJ 17,
  • Santingamkun A 18,
  • Tsang WC 3,
  • Abrams P 19,
  • Ho LY 1,
  • Chu PS 2,
  • Consigliere DT 3,
  • Zainuddin ZM 4,
  • Bolong D 5,
  • Chan CK 6,
  • Eng M 7,
  • Huynh DN 8,
  • Kochakarn W 9,
  • Lapitan MCM 10,
  • Le DK 11,
  • Le QD 7,
  • Lee F 13,
  • Lojanapiwat B 14,
  • Nguyen BN 15,
  • Ong TA 16,
  • Reyes BJ 17,
  • Santingamkun A 18,
  • Tsang WC 3,
  • Abrams P 19
1 Asia Clinic, Hong Kong, China 2 Division of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong, China 3 Department of Urology, University Surgical Cluster, National University Hospital, Singapore, Singapore 4 Urology Unit, Department of Surgery, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia 5 Department of Surgery, University of Santo Tomas Hospital, Metro Manila, Philippines 6 Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China 7 Department of Surgery, Khoo Teck Puat Hospital, Singapore, Singapore 8 Department of Urology, University Medical Center, Ho Chi Minh City Medicine and Pharmacy University, Ho Chi Minh, Vietnam 9 Division of Urology, Department of Surgery, Ramathibodi Hospital, Bangkok, Thailand 10 Division of Urology, Department of Surgery, University of the Philippines - Manila, Philippine General Hospital, Metro Manila, Philippines 11 Department of Urology, Hue University Hospital, Hue University of Medicine and Pharmacy, Hue, Vietnam 12 Department of Surgery, Can Tho National General Hospital, Can Tho, Vietnam 13 The Princess Grace Hospital, London, UK 14 Department of Surgery, Chiang Mai University, Chiang Mai, Thailand 15 Bach Mai Hospital, Hanoi, Vietnam 16 Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia 17 St Luke's Medical Centre, Manila, Philippines 18 Chulalongkorn University, Bangkok, Thailand 19 Bristol Urological Institute, Southmead Hospital, Bristol, UK 1 Asia Clinic, Hong Kong, China 2 Division of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong, China 3 Department of Urology, University Surgical Cluster, National University Hospital, Singapore, Singapore 4 Urology Unit, Department of Surgery, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia 5 Department of Surgery, University of Santo Tomas Hospital, Metro Manila, Philippines 6 Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China 7 Department of Surgery, Khoo Teck Puat Hospital, Singapore, Singapore 8 Department of Urology, University Medical Center, Ho Chi Minh City Medicine and Pharmacy University, Ho Chi Minh, Vietnam 9 Division of Urology, Department of Surgery, Ramathibodi Hospital, Bangkok, Thailand 10 Division of Urology, Department of Surgery, University of the Philippines - Manila, Philippine General Hospital, Metro Manila, Philippines 11 Department of Urology, Hue University Hospital, Hue University of Medicine and Pharmacy, Hue, Vietnam 12 Department of Surgery, Can Tho National General Hospital, Can Tho, Vietnam 13 The Princess Grace Hospital, London, UK 14 Department of Surgery, Chiang Mai University, Chiang Mai, Thailand 15 Bach Mai Hospital, Hanoi, Vietnam 16 Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia 17 St Luke's Medical Centre, Manila, Philippines 18 Chulalongkorn University, Bangkok, Thailand 19 Bristol Urological Institute, Southmead Hospital, Bristol, UK
Commentary by Antonella Giannantoni

In this study, the Authors presented the results of a large-scale, multinational survey— designed to investigate patients’ perspectives on LUTS and their treatment in Southeast Asia. The survey involved major urology centres in Southeast Asia. The primary aim of the study was to investigate the prevalence of the four symptoms: urgency, nocturia, slow stream, and post-micturition dribble in LUTS patients presenting to a urologist. Among secondary objectives there were the assessment of the bother of the four symptoms, the age distribution of the four symptoms, and the identification of the most bothersome LUTS among the symptoms. A patient self-administered questionnaire which was developed by the Southeast Asia Urology Think Tank, including a group of urology specialists, was given to the selected patients for the survey. Eligible patients were 1535; the majority of respondents were aged 56–75 years, not employed, and had not undergone prostate operation before. Overall, the self-reported prevalence of nocturia was 88%, slow stream 61%, post micturition dribble 55%, and urgency 52%. More frequently all symptoms coexisted and were combined with nocturia, while only 18% of partecipants complained of only one urinary disturbance, which was more commonly represented by nocturia. Variations between the individual countries and overall population have been observed, with Hong Kong presenting with a prevalence significantly higher than the overall results, with regard to nocturia, slow stream, and post-micturition dribble. On the contrary, Malaysia reported significantly lower prevalence than the overall population for all four symptoms studied.

The main relevant observation coming from the results of this large-scale southeast Asian survey is that in the secondary care setting, LUTS often co-existed and were combined with nocturia in the majority of men. Again, nocturia appears to be one of the most prevalent and bothersome LUTS also in southeast asian men.

Commentary by Antonella Giannantoni

In this study, the Authors presented the results of a large-scale, multinational survey— designed to investigate patients’ perspectives on LUTS and their treatment in Southeast Asia. The survey involved major urology centres in Southeast Asia. The primary aim of the study was to investigate the prevalence of the four symptoms: urgency, nocturia, slow stream, and post-micturition dribble in LUTS patients presenting to a urologist. Among secondary objectives there were the assessment of the bother of the four symptoms, the age distribution of the four symptoms, and the identification of the most bothersome LUTS among the symptoms. A patient self-administered questionnaire which was developed by the Southeast Asia Urology Think Tank, including a group of urology specialists, was given to the selected patients for the survey. Eligible patients were 1535; the majority of respondents were aged 56–75 years, not employed, and had not undergone prostate operation before. Overall, the self-reported prevalence of nocturia was 88%, slow stream 61%, post micturition dribble 55%, and urgency 52%. More frequently all symptoms coexisted and were combined with nocturia, while only 18% of partecipants complained of only one urinary disturbance, which was more commonly represented by nocturia. Variations between the individual countries and overall population have been observed, with Hong Kong presenting with a prevalence significantly higher than the overall results, with regard to nocturia, slow stream, and post-micturition dribble. On the contrary, Malaysia reported significantly lower prevalence than the overall population for all four symptoms studied.

The main relevant observation coming from the results of this large-scale southeast Asian survey is that in the secondary care setting, LUTS often co-existed and were combined with nocturia in the majority of men. Again, nocturia appears to be one of the most prevalent and bothersome LUTS also in southeast asian men.