Relationship between Lower Urinary Tract Symptoms and Emotional State among a Sample of Clinic Attendees of a Tertiary Care Center in Central Sri Lanka

Author(s): Pethiyagoda AUB, Pethiyagoda K, Ariyasinghe DI, Wijesinghe S, Dimiyawa KM, Wijethunga TM

Introduction: Lower Urinary Tract Symptoms (LUTS) is a set of symptoms that correlates to the human urinary tract. Among the many reasons associated with LUTS, numerous studies have shown an association between LUTS and the emotional state of patients. Various researches in different geographical locations have been conducted to assess this relationship between LUTS and mental health in different ways. Findings from previous studies were highly dependent on the methodologies and criteria used. The purpose of this study is to evaluate any relationship between LUTS and the emotional state of patients in a sample of clinic attendees of General Urology (GU) clinic in Teaching Hospital, Peradeniya, Sri Lanka where the emotional state is assessed through criteria for depression, anxiety and stress. Here, International Prostate Symptom Score (IPSS) is used as the screening tool to evaluate LUTS and Depression Anxiety Stress Scale-21 (DASS-21) is used to quantify the emotional state.

Methodology: This is a descriptive, cross-sectional study performed among patients attending the GU clinic at Teaching Hospital Peradeniya, Sri Lanka to identify the relationship between LUTS and the emotional state. Study samples were collected from July 2020 to October 2021. Subjects were asked questions using a questionnaire on the presence of Lower Urinary Tract Symptoms and the emotional state. Data analysis was performed using SPSS version 20. The association between IPSS and DASS-21 scores was analyzed using simple linear regression analysis.

Results: The study group consisted of 161 patients who attended the GU clinic at the Teaching Hospital, Peradeniya. 84.5% of the sample was male while 15.5% was female. The mean age of the studied group was 62 ± 14.51 (p<0.005). The highest prevalent symptom was nocturia (81%). The mean total IPSS score was approximately 17. Among 161 patients 36.17%, 50.35% and 30.5% people had mild – extremely severe depression, anxiety and stress respectively. According to the coefficients of linear regression analysis, the most significant correlation was observed among LUTS and depression (p = 0.001). When IPSS score was increased by 1, depression score is predicted to be increased by .292. Similarly, when IPSS score was increased 1, anxiety score is predicted to be increased by .221 (p = 0.003) and stress score is predicted to be increased by .257 (p = 0.008).

Conclusion: A clear association of stress with the LUTS was observed in a sample of 161 patients attending the GU clinic at Teaching Hospital, Peradeniya. The most prevalent LUT symptom was nocturia. Anxiety was the most prevalent emotional issue out of stress, anxiety and depression. Maximum correlation was observed among depression and LUTS with a higher significance.

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