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Purpose: To investigate the prevalence of lower urinary tract symptoms/benign prostatic hyperplasia in a Korean population. Materials and Methods: The Korean Prostate & Voiding Health Association provided free prostate-related community health care and conducted surveys in all regions of Korea from 2001 to 2022 with the cooperation of local government public health centers. A total of 72,068 males older than 50 were surveyed and analyzed. History taking, International Prostate Symptom Score (IPSS), transrectal ultrasonography, prostate-specific antigen (PSA) testing, uroflowmetry, and urine volume testing were performed. Results: The mean prostate volumes in males in their 50s, 60s, 70s, and 80s or above were 24.7 g, 27.7 g, 31 g, and 33.7 g, respectively. The proportion of males with high PSA greater than 3 ng/mL was 3.8% among males in their 50s, 7.7% among males in their 60s, 13.1% among males in their 70s, and 17.9% among males 80 years of age or older. The mean IPSS total scores in males in their 50s, 60s, 70s, and 80s or above were 10.7, 12.7, 14.5, and 16, respectively. Severe symptoms were reported by 27.3% of males, whereas 51.7% reported moderate symptoms. The mean Qmax in males in their 50s, 60s, 70s, and 80s or above were 20 mL/s, 17.4 mL/s, 15.4 mL/s, and 13.8 mL/s, respectively. Conclusions: In this population-based study, mean prostate volume, IPSS, PSA, and Qmax were 30.6±15.1 g, 14.8±8.2, 1.9±4.7 ng/mL, and 15.6±6.5 mL/s, respectively. Aging was significantly associated with increased prostate volume, PSA levels, and IPSS scores, and with decreased Qmax and urine volume. [ABSTRACT FROM AUTHOR]

Purpose: Lower urinary tract symptoms (LUTS) affect over half of the adults' population worldwide, with an increasing prevalence among the older age groups. Therefore, with the increasing elderly population, LUTS is an important disease, highlighting the need for accurate data on its prevalence. This present study aimed to investigate the prevalence of LUTS in South Korea. Methods: The study targeted individuals aged at least 19 years nationwide. We conducted computer-assisted telephone interviews, 80% mobile random digital dialing (RDD) sampling frame, and 20% landline RDD sampling frame between April and May 2020. Questionnaires included The International Prostate Symptom Score (IPSS), the overactive bladder symptom score (OABSS), and the characteristics of respondents. Current International Continence Society definitions were used for individual LUTS and OAB. Results: There were 2,000 respondents, 1,009 (50.4%) were women and 546 (27.3%) were aged =60 years. Based on our IPSS questionnaire survey results, 77.9% of the respondents had LUTS; 63.7% had mild symptoms (1-7), 11.7% had moderate symptoms (8-19), and 2.4% had severe symptoms (20-35). The prevalence and severity of LUTS increased with age with 22.1% of respondents aged 60 years and above complaining of moderate or severe LUTS. According to the survey through OABSS, the prevalence of OAB was 9.6%, males were 10.3% and females were 9.0%. Conclusions: Based on our survey results, 77.9% of the Korean adult population (over the age of 19) experienced at least one LUTS, and the severity increased with age. The prevalence and severity of OAB increased with age, especially after 40 years; the prevalence of OAB was 9.6%, and 13.4% of them were over 60 years old. [ABSTRACT FROM AUTHOR]

Purpose: With a rapidly aging population in Korea, the number of patients with lower urinary tract symptoms is increasing. Therefore, it is important to determine the current extent of incontinence among Korean women to establish future plans. We attempted to create reference materials for organizing public relations and educational activities by investigating the effect of age on incontinence and quality of life in women. Materials and Methods: The participants comprised women aged 30 years and older who visited a tertiary center for health screening from September 1 to October 31, 2016. The survey included a questionnaire consisting of 12 questions that took approximately 10 minutes to complete. We analyzed the responses and assessed the prevalence of the disease and its rate of recognition. Results: A total of 509 women completed the survey. Irrespective of age, 76.8% of all respondents were aware of urinary incontinence (UI) and 57.4% of the women exhibited lower urinary tract symptoms. The most prevalent symptom was UI (45.8%), and the incidence rates of stress and urge UI were identified as 33.6% and 12.2%, respectively. Only 8.0% of the women had visited a hospital; 38.3% had awaited spontaneous symptom improvement. Many participants (61.2%) answered that a urology clinic is suitable for treating UI, while 58.9% chose a gynecology clinic. Conclusions: Our study showed that more than 75% of women are aware of UI, but their perception of the disease mechanism and treatment options was low. We suggest that continuous education and publicity are necessary. [ABSTRACT FROM AUTHOR]

The prevalence of benign prostatic hyperplasia (BPH) is rising with Korea becoming an aging society. As patients age, their comorbidities and the risks associated with anesthesia increase. Recently, there has been an increasing concern regarding sexual function after surgery. As a result, interest in minimally invasive surgery for BPH that does not require anesthesia or affect sexual function has grown. This review article introduces newly developed minimally invasive surgeries for BPH divided into four categories based on the strategy--mechanical, anatomical, atrophic, and laparoscopic. Here, the mechanisms for each surgical method have been introduced. Furthermore, recent representative studies of these procedures with a focus on randomized controlled trials and meta-analyses have also been reviewed. Side effects related to sexual function have also been mentioned briefly along with the efficacy and indication for robotic BPH surgery, which has recently been attracting attention. However, these newer, minimally invasive procedures require additional comparative randomized controlled trials and long-term results to produce more robust evidence for their use. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the correlation between lower urinary tract symptoms (LUTSs) and falls considering places where falls can occur in adult males. We analyzed 101 862 males in the 2011 Korean Community Health Survey. LUTSs were assessed using the International Prostate Symptom Score system. The rate of total and indoor falls significantly increased with the LUTS severity, respectively. After adjusting for age and other confounding variables, the odds ratios (ORs) for total falls were significantly high for the mild (OR = 1.63, 95% confidence interval [CI] = 1.54-1.71), moderate (OR = 2.35, 95% CI = 2.16-2.56), and severe groups (OR = 2.83, 95% CI = 2.49-3.22), relative to the normal group. Indoor fall experience was the same for the mild (OR = 1.56, 95% CI = 1.36-1.79), moderate (OR = 2.37, 95% CI = 1.97-2.85), and severe groups (OR = 3.77, 95% CI = 3.00-4.72). Nocturia, hesitancy, and urgency were significantly associated with indoor falls. The association between falls and the degree of LUTS was observed in both the young and the elderly. Therefore, further studies are needed to determine the effects of treatment of LUTS on the risk of falls and the effectiveness of the fall prevention program. [ABSTRACT FROM AUTHOR]

• Lower urinary tract symptoms (LUTS) were prevalent in male stroke survivors. • The IPSS may be useful for evaluating LUTS in male stroke patients. • Stroke may independently contribute to the development of LUTS. There is a scarcity of large population-based studies investigating lower urinary tract symptoms (LUTS) using the International Prostate Symptom Score (IPSS) in stroke survivors. We investigated the prevalence and severity of LUTS in male stroke survivors and determined the independent effect of stroke on LUTS using data from a nationwide population-based survey. Cross-sectional data obtained from the 2011 Korean Community Health Survey were analyzed. The prevalence and severity of LUTS were compared between 1936 male stroke patients and 90,506 male non-stroke participants. Multivariable logistic regression was used to identify the independent effect of stroke on LUTS. Male stroke patients more frequently reported both storage symptoms (frequency, urgency, and nocturia) and voiding symptoms (straining, weak stream, intermittency, and incomplete emptying) compared to male non-stroke population. The storage and voiding subscores of IPSS and quality of life score were higher in male stroke patients than in male non-stroke population. Multivariable logistic regression adjusted for age, socioeconomic factors, physical and mental health measures, and comorbidities, found stroke to be an independent risk factor for all 7 symptoms of LUTS. The present study confirmed a high prevalence of LUTS in male stroke survivors that cannot be attributed only to potential confounders, implying that stroke may independently contribute to the development of LUTS. Our findings warrant the need for timely detection by physicians and proper management of LUTS to promote functional outcomes and quality of life in stroke population. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the categories of nocturia and relationships with the international prostate symptom score (IPSS) in Korean men with lower urinary tract symptoms (LUTS) accompanying nocturia. Materials and Methods: Five hundred twenty-one male patients from five different hospitals, aged =18 years, were included. The 3-day frequency volume chart was used to identify nocturia. We also used the IPSS and The International Consultation on Incontinence Modular Questionnaire-Nocturia (ICIQ-N) module to verify the correlation between nocturia and quality of life. Results: The distribution of nocturia events varied from 1 to 11, and 2 nocturia events were most prevalent (48.4%). Across the various numbers of nocturia events, the mean age, first sleep period, functional bladder capacity (FBC), nocturnal polyuria index (NPI), nocturia index (NI), predicted number of nightly voids, and nocturnal bladder capacity index (NBCI) were statistically different. Patients with pure nocturnal polyuria showed different night lengths, nocturnal urine volume, FBC, NPI, NI, and predicted number of nightly voids than those without nocturnal polyuria. Patients with severely reduced NBCI were prominent in the IPSS >20 group, and the degree of vexation increased with the number of nocturia events. The IPSS storage symptom score and ICIQ-N symptom score positively correlated with nocturia events. Conclusions: In Korean male LUTS patients with nocturia, mixed-type nocturia was prominent, and patients with a high IPSS had a much poorer sleep quality than those with a low IPSS. [ABSTRACT FROM AUTHOR]

Objective: Lower urinary tract symptoms (LUTS) in males can reduce patients' quality of life (QoL) and affect sexual function and satisfaction. Although this has been documented in the US, Canada, Germany, Italy, UK, and Sweden, data are limited on the effects of LUTS on QoL and sexual function in Asian men. The present subgroup analysis of an Internet‐based survey correlated the incidence of male LUTS by severity and category with self‐assessed QoL and sexual function and satisfaction measures. Methods: Males aged ≥40 years were randomly selected from consumer survey panels in China, Taiwan, and South Korea. LUTS were defined using the International Continence Society (ICS) 2002 symptom definitions; symptom severity was assessed by the International Prostate Symptom Score (IPSS). The effect of LUTS on QoL was assessed using Patient Perception of Bladder Condition (PPBC) and IPSS QoL scores. Sexual function and satisfaction were assessed using the International Index of Erectile Function (IIEF). Results: Men with moderate‐to‐severe LUTS and overlap of voiding, storage, and post‐micturition symptom categories reported dissatisfaction with their QoL and sexual function. LUTS severity was negatively correlated with IIEF scores. Overlap of LUTS categories had a greater effect on QoL and sexual satisfaction than the incidence of just 1 LUTS. Conclusion: The findings of the present study suggest that LUTS is prevalent in >60% of Asian males aged ≥40 years and is associated with reduced QoL and sexual function, particularly in those with overlap of LUTS categories and greater symptom severity. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the factors affecting the quality of life of patients with radical prostatectomy. Methods: Participants included 114 patients with radical prostatectomy in Pusan National University Hospital in Busan, Korea. Data were collected from May to July 2018, using a structured questionnaire measuring quality of life, erectile dysfunction, lower urinary tract symptoms, appraisal of uncertainty, resilience, educational needs for sexual health, and marital intimacy. Data were analyzed using descriptive statistics, an independent t-test, a one-way analysis of variance, and hierarchical multiple regression. Results: The statistically significant regression model explained about 77% of the variance in quality of life. Appraisal of uncertainty as an opportunity, appraisal of uncertainty as a danger, and resilience were identified as factors influencing the participants' quality of life. Conclusion: In order to improve the quality of life of patients with radical prostatectomy, it is necessary to reduce uncertainty through providing practical information on uncertain situations, and the programs should be applied that can lower the danger aspect of uncertainty, increase the opportunity factor of uncertainty, and increase the resilience of the patient himself. [ABSTRACT FROM AUTHOR]

Purpose: Urinary incontinence (UI) is associated with nursing home admission, functional decline, and risk of death among community-dwelling older adults. Little information, however, is available on sex differences in lower urinary tract symptoms (LUTS) in older Korean adults exclusively living in rural areas. This study examined sex-related differences in LUTS, factors associated with UI in older adults living in rural areas, and health-related quality of life (HRQoL) in incontinent older adults. Methods: This was a cross-sectional study in which face-to-face interviews were conducted at 15 rural community-health centres. A total of 323 older adults aged ⩾65 years from rural areas of Korea participated. LUTS prevalence was evaluated and HRQoL was measured using the King's Health Questionnaire. The chi-square test and t -test were used to examine sex differences in characteristics, LUTS, and HRQoL. Multivariable logistic regression was used to identify risk factors associated with UI. Results: Nocturia was the most prevalent symptom, affecting 87% of men and 86% of women. Women (53%) had significantly more UI of any kind than did men (35%) (P=0.007). Urgency UI was the most frequent type of UI in men, whereas stress UI was the most frequent in women. Regarding HRQoL, men had significantly higher scores in the domains of sleep/energy disturbances (P=0.032) than did women, and women reported greater effects from the severity of incontinence (P=0.001) than did men. Arthritis was the only factor associated with UI in men (odds ratio [OR], 6.88; 95% confidence interval [CI], 1.46- 32.36). However, women with diabetes mellitus were less likely to have UI than those without (OR, 0.43; 95% CI, 0.23-0.82). Conclusions: LUTS were found to be highly prevalent in community-dwelling older Korean adults in rural areas. Interventions to improve sleep and to reduce UI severity are needed for incontinent men and women, respectively. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the effects of erectile capacity, lower urinary tract symptoms, self-esteem, and resilience on the quality of life of prostate cancer patients. Methods: Data were collected using a self-reported questionnaire survey. Participants were 140 patients diagnosed and treated for prostate cancer in hospitals in Busan and Daegu cities. Measured variables were erectile capacity, lower urinary tract symptoms, self-esteem, resilience and quality of life. Result: Erectile capacity, lower urinary tract symptoms, self-esteem, and resilience all had significant effects on quality of life. Explained variance for quality of life was 40.6% and lower urinary tract symptoms was the most significant factor affecting the quality of life of prostate cancer patients. Conclusion: The results from this study suggest that erectile capacity, lower urinary tract symptoms, self-esteem, and resilience should be considered the main influential factors when developing intervention strategies to increase the quality of life of prostate cancer patients. [ABSTRACT FROM AUTHOR]

Background: Lower urinary tract symptoms (LUTS) and overactive bladder (OAB) symptoms have a substantial effect on quality of life (QoL). We report QoL and mental health results from a LUTS prevalence study in three Asian countries.Methods: A cross-sectional, population-representative, internet-based study among individuals aged ≥40 years in China, Taiwan and South Korea. Instruments included: Overactive Bladder Symptom Score (OABSS); International Prostate Symptom Score (IPSS); other International Continence Society (ICS) symptom questions; health-related QoL 12-item short-form (HRQoL-SF12v2); Work Limitations Questionnaire (WLQ); Hospital Anxiety and Depression Scale (HADS). Presence of LUTS was determined according to ICS criteria, with three symptom groups (storage, voiding and post-micturition). Post-stratification weighting matched the age and sex population distribution per country. Initial data analyses were based on descriptive statistics. Significance testing undertaken post hoc included: independent-samples t-test (differences in HRQoL between sexes and between individuals with/without LUTS; relationship between HRQoL score and OABSS; differences in HADS anxiety and depression scores between individuals with/without LUTS; association between HADS anxiety/depression scores and OABSS), chi-square test (association between LUTS prevalence and workplace productivity) and analysis of variance (differences in HRQoL score and in HADS anxiety/depression scores between individuals with different symptom groups, association between HADS anxiety/depression scores and IPSS).Results: In total, 8284 participants were included. HRQoL scores were significantly worse (p < 0.001) among individuals with versus without LUTS (ICS criteria): mean physical health domain scores were 61.1 (standard deviation [SD], 20.1) and 76.7 (17.0), respectively; corresponding mental health domain scores were 34.8 (12.7) and 43.7 (10.7). Workplace productivity was best among individuals without LUTS (difficulties reported by 2-3% of individuals), and worst in those with all three ICS symptom groups (difficulties reported by 29-38% of individuals; p = 0.001). Mean HADS scores showed significantly worse (p < 0.001) levels of anxiety and depression among individuals with versus without LUTS: anxiety, 6.5 (SD, 3.7) and 4.0 (3.3); corresponding mean depression scores were 6.8 (4.3) and 4.2 (3.6). Increasing OAB severity was also associated with decreasing HRQoL physical and mental health scores.Conclusion: LUTS and increasing OAB severity are both associated with impaired QoL, reduced workplace productivity, and increased tendency towards anxiety and depression. These results highlight the need to ensure that individuals with LUTS receive appropriate, effective treatment.Trial Registration: ClinicalTrials.gov identifier: NCT02618421 , registered 26 November 2015 (retrospectively registered). [ABSTRACT FROM AUTHOR]

Introduction: Few population-based data are available evaluating the prevalence of lower urinary tract symptoms (LUTS) in Asia. The objective of our study was to determine LUTS prevalence in China, Taiwan, and South Korea using International Continence Society (ICS) 2002 criteria.Methods: An Internet-based self-administered survey among individuals aged at least 40 years with the ability to use a computer and to read the local language. Survey questions included ICS symptom definitions and the international prostate symptom score (IPSS). Data analysis was based on descriptive statistics and post hoc significance testing.Results: There were 8284 participants, of whom 51% were women and 34% were aged at least 60 years. LUTS prevalence was slightly higher in men than women (62.8% vs. 59.6%; p = 0.004), increasing significantly with age (p = 0.001). All three ICS symptom groups (voiding, storage, and post-micturition) were present in 35% of individuals with LUTS. Symptoms with the highest overall prevalence were nocturia, frequency, incomplete emptying, and terminal dribble. The most bothersome symptoms were terminal dribble, nocturia, and urgency. According to IPSS scores, 87% of participants had at least mild symptoms; 43% of those aged over 60 years had moderate/severe symptoms. The percentage of participants with any LUTS who had visited healthcare professionals because of urinary symptoms was 26%, rising to 45% amongst individuals with all three symptom groups (p = 0.001 vs. other ICS symptom groups).Conclusions: LUTS are highly prevalent in men and women aged at least 40 years who participated in this study in China, Taiwan, and South Korea and increases with increasing age. A minority of individuals with LUTS seek healthcare and our results suggest an increased patient awareness of LUTS is required.Funding: Astellas Pharma Singapore Pte. Ltd.Trial Registration: ClinicalTrials.gov identifier, NCT02618421. [ABSTRACT FROM AUTHOR]

This review assessed the epidemiology of voiding dysfunctions in South Korea. Comprehensive understanding of this epidemiology is crucial because the senior population and the social burden are increasing because of voiding dysfunctions is growing. We searched the medical records using several terms related to voiding dysfunction: benign prostatic hyperplasia, urinary incontinence, lower urinary tract symptoms, overactive bladder, and nocturia. We then estimated the prevalence of voiding dysfunctions in South Korea; our data were comparable with those from other countries, with slight differences. The ranges of incidences varied widely between studies, mostly because investigators defined disorders differently. Voiding dysfunction greatly affects healthcare costs and individual quality of life; therefore, more proper and valuable epidemiologic data are needed. In addition, efforts to unify the definitions of various voiding dysfunctions and progress in investigational methodologies using multimedia are warranted. [ABSTRACT FROM AUTHOR]

Purpose: To examine the impact of lower urinary tract symptoms (LUTS) on health-related quality of life (HRQoL) in Korean men aged =40 years. Methods: A population-based, cross-sectional door-to-door survey was conducted among men aged =40 years. Individuals with LUTS were defined as men reporting at least one LUTS using 2002 International Continence Society definitions. Structured questionnaires were used to assess several dimensions of HRQoL, including generic health status (EuroQoL-five-dimensions questionnaire), work productivity (work productivity and activity impairment questionnaire), depressive symptoms (center for epidemiologic studies depression scale), and sexual health (sexual satisfaction and erectile dysfunction). The impact of LUTS was assessed by comparing several dimensions of HRQoL among men with and without LUTS. Results: Of the 1,842 participants, 1,536 (83.4%) reported having at least one LUTS. The prevalence of LUTS increased with age (78.3% among those aged 40-49 years to 89.6% among those aged 60 years or older). Those with LUTS reported a significantly lower level of generic health status and worse work productivity compared with those without LUTS. Significantly more individuals with LUTS reported having a higher level of major depressive symptoms compared with those without LUTS. Those with LUTS reported worse sexual activity and enjoyment, and were significantly more likely to have erectile dysfunction than those without LUTS. Conclusions: LUTS seem to have a substantial impact on several dimensions of HRQoL in Korean men aged =40 years. [ABSTRACT FROM AUTHOR]

Objectives To gain further evidence on the efficacy, safety and tolerability of tadalafil 5 mg once-daily in Asian men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Methods Japanese and Korean men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia were randomized to once-daily tadalafil 5 mg ( n = 306) or placebo ( n = 304) for 12 weeks. Results A significantly greater improvement ( P < 0.001) in total International Prostate Symptom Score for the change from baseline (week 0) to study end-point (week 12) was observed for tadalafil (−6.0) versus placebo (−4.5). Significantly greater improvements ( P < 0.01) in total International Prostate Symptom Score for the change from baseline to weeks 4 and 8 were observed for tadalafil versus placebo. Significantly greater improvements ( P < 0.05) in International Prostate Symptom Score voiding and storage subscores, and International Prostate Symptom Score Quality of Life Index were observed for the change from baseline to end-point for tadalafil versus placebo. Significantly greater improvements ( P < 0.001) in urinary symptoms were observed for tadalafil versus placebo for both Patient and Clinician Global Impressions of Improvement. No new safety concerns were identified. Conclusions These findings confirm the efficacy and safety profile of tadalafil 5 mg once-daily in Asian men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed at investigating sexual behavior patterns of elderly residents of urban areas in South Korea and their correlation with lower urinary tract symptoms. Materials and Methods: From May, 2009 to October, 2009, 154 males and 299 females over 60 years old who visited senior welfare centers of Seoul were administered a questionnaire on sex life patterns and voiding symptoms. Results: Among the 154 males, 59 (38.3%) had sexual intercourse at least one time per month. The remaining 95 males (61.7%) did not have sexual intercourse, because of impotence for 52 males (52.6%), no sexual desire for 28 males (29.4%), and sex partner's problems for 15 males (15.7%). The higher International Prostate Symptom Score was, the lower International Index of Erectile Dysfunction-5 was (p=0.035). Among 299 females, 37 (12.4%) had sexual intercourse at least one time per month. The remaining 262 females (87.6%) did not have sexual intercourse, because of no spouse for 163 females (63.2%), no sexual desire for 48 females (18.6%), the spouse's impotence for 34 females (13.2%), and the spouse's bad health for 10 females (3.9%). It was found that self-diagnosis of overactive bladder affects sex life negatively. Conclusions: The sexual behaviors of the elderly included varying activity. Sexual intercourse were significantly associated with lower urinary tract symptoms. Our results suggest that the counseling with the elderly about sexual health is as important as it is with non-elderly individuals. [ABSTRACT FROM AUTHOR]