Lower urinary tract symptoms (LUTS) are a common health problem among both men and women and increase with age. LUTS negatively impact several aspects of patients’ quality of life (QOL), including their daily activities, sleep, personal relationships, and mental health. An appropriate management and treatment of LUTS, such as lifestyle modification, pelvic floor muscle exercise, medication, and surgical treatment can improve patients’ QOL. However, most of people are reportedly unaware of this disease even in health care provider. The aim of this study was to clarify the prevalence of LUTS and to visible distress accompanying LUTS in a common examinee population undergoing medical checkups. Moreover, to reveal whether there were different behavior between males and females for their LUTS.

This study was a cross-sectional, study conducted in communities located in Japan. A total of 723 (441 males, 282 females) residents aged >40 years who presented for a medical examination were enrolled in this study. Approval for the study was obtained from the local institutional ethics committee. Residents who were asked to participate were provided anonymous questionnaires. To evaluate LUTS, the following tools were used; the International Prostate Symptom Score (IPSS), the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), overactive bladder symptom score (OABSS, which assesses daytime urinary frequency and nighttime urinary frequency, urgency, and urge urinary incontinence and has been validated in Japan), and original questionnaire inquiring about patients’ distress and behavior with LUTS. The chi-squared test was used to evaluate the prevalence of LUTS between the sexes, and p-values of <0.05 were considered statistically significant.

Of the 723 participants, women comprised 39.0% of the participants. The highest age among the participants was 40-49 years (37.1%), and participants decrease with age. The prevalence of LUTS was higher in women than in men, but the difference was not statistically significant (28.7% in men vs. 32.4% in women; n.s.). Among the patients with LUTS, nocturia had the highest prevalence in men, with a significantly higher rate in men (18.0% in men vs. 12.9% in women; p<0.05). The prevalence of overactive bladder was higher in men than in women, but the difference was not statistically significant (13.9% in men vs. 12.7% in women; n.s.). In contrast, the prevalence of urinary incontinence was significantly higher in women than in men (8.4% in men vs. 24.5% in women; p<0.05) and the highest prevalence in women. The rate of distress with LUTS was similar in both sexes (19.3% in men vs. 19.9% in women; n.s.). However, among individuals experiencing distress, the rate of those intending to consult a physician was significantly higher in women than in men (38.5% in men vs. 62.8% in women; p<0.05), and significantly more women had never visited a physician (79.9% in men vs. 97.6% in women; p<0.05). The reasons provided by distressed individuals for not visiting a physician were “symptoms do not occur often” (40.7% in men vs. 38.6% in women; n.s.), “embarrassment” (0% in men vs. 12.3% in women; p<0.05), “no time” (4.7% in men vs. 1.8% in women; n.s.).

This study clearly demonstrated that overall prevalence of LUTS and distress with LUTS were similar in both sexes, but women were more embarrassed to visit a medical institution to consult a physician than men among a medical checkup examinee population.

To the best of our knowledge, this is the first report to evaluate not only the prevalence and distress of LUTS but also detect the different behavior between males and females for their LUTS in medical examination population in Japan. Adequate education regarding LUTS is more needed to encourage patients, particularly females, to visit their physicians to improve their LUTS.