TUESDAY, May 3, 2022 (HealthDay News) — Urinary incontinence can afflict men as they age, but a new study suggests it could be more than just an embarrassing condition and could actually be a warning sign. -Runner from an early death.
“This indicates the importance of assessing general health status, risk factors and major comorbidities in men with LUTS. [lower urinary tract symptoms]“, wrote the researchers, led by Jonne Akerla of the Department of Urology at Tampere University Hospital in Finland.
The team analyzed LUTS in more than 3,000 Finnish men who had enrolled in a study in 1994, when they were 50, 60 or 70 years old. The research included a 24-year follow-up in 2018 of 1,167 of the men. About half had died in the years that followed.
The team looked at the men’s lower urinary tract symptoms as a risk factor for death, taking into account age and other medical conditions and looking at whether the symptoms “bothered” the men.
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In general, moderate and severe lower urinary tract symptoms were markers of poor health, according to the team.
Dr. Craig Comiter, professor of urology at Stanford University School of Medicine in California, found the study intriguing, as previous studies have shown no link between mortality and incontinence.
“The authors are to be commended for their measured conclusions, hypothesizing that urinary symptoms are more of a marker of poor health than a direct cause of death,” Comiter said. He described LUTS as any disorder that affects urinary storage, including excessive urine production, incomplete bladder emptying, neurological and myogenic (muscular) bladder disorders, and benign prostate obstruction.
These urinary dysfunctions can be caused by a variety of common medical conditions, including heart or neurological disease, diabetes, sleep disorders, reduced mobility, Parkinson’s disease, dementia, stroke, and multiple sclerosis.
In this study, men who had moderate to severe bladder emptying symptoms (such as hesitation, weak jet, and straining) had a 20% increased risk of death during the study period. Those who had what are considered “storage” symptoms, such as frequent urination during the day, incontinence and nocturia (waking up at night to urinate), had a 40% increased risk of death. during the study.
Even for those in the study with mild symptoms, if they had a daytime frequency, the risk of death was increased by 30%. If they had nocturia, the risk of death was increased by 50%.
The need to urinate at night or more than every three hours during the day could be “significant for the patient”, especially if it is persistent, the researchers said.
Frequent urinary incontinence had a particularly strong association with risk of death, suggesting that urinary urgency has a significant impact on health and functional status in aging men, the authors said, and may have been a reflection of long-term neurological or vascular disease.
The results were published online recently in the Journal of Urology.
Dr. Anthony Schaeffer, professor of urology at Northwestern University Feinberg School of Medicine in Chicago, said he thought the results might be statistically significant, but not clinically meaningful.
“There is a slight increase in mortality, but the comorbidities [other health conditions] exist in these men,” Schaeffer said.
“What do you do about it? What you do about it is what we all do, we treat these people,” he said.
Schaeffer said there is no evidence that treating people with LUTS improves their life expectancy.
LUTS are usually diagnosed by symptoms, and doctors treat them with a variety of options according to American Urological Association guidelines, Schaeffer said, including medications and surgery.
He pointed out that randomized controlled trials (the gold standard of research) would be needed to show that treating LUTS reduces your risk of early death.
No previous studies have linked incontinence to death, Comiter said, adding that the fact that this study shows that urge incontinence and premature death may in fact be linked is important.
“Further research needs to investigate the role of ‘restricted mobility’ as a link between frailty and incontinence, as such restricted mobility may be the factor that turns frequent, urgent urination into frank incontinence,” Comiter said. “In addition, studies in younger populations are essential to see if there is a true causal link between urinary symptoms and mortality or if there is [is] simply a marker of poor health in the elderly.”
The US National Library of Medicine has more on lower urinary tract symptoms in men.
SOURCES: Craig Comiter, MD, professor of urology and professor of obstetrics and gynecology (courtesy), Stanford University College of Medicine, Stanford, Calif.; Anthony Schaeffer, MD, professor of urology, Northwestern University Feinberg School of Medicine, Chicago; the Journal of UrologyApril 26, 2022, online
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