Urinary problems may increase death risk in older men

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In a recent study from Tampere University, scientists found that for men in their fifties and older, moderate to severe lower urinary tract symptoms (LUTS) such as incontinence and frequent nighttime urination (nocturia) are linked to an increased risk of death.

Some associations with mortality are noted even when urinary symptoms are not very bothersome for the patient—and might not be considered to require treatment.

In the study, the team used data from a long-term follow-up study of men’s health and analyzed lower urinary tract symptoms in more than 3,000 Finnish men who were 50, 60, or 70 years old when enrolled in the study in 1994.

The current analysis included data on 1,167 men who were followed up through the end of 2018. About half of the men died during this 24-year follow-up period.

For urologists, symptom “bother” is an important consideration: men who say their urinary symptoms don’t bother them very much are considered to be successfully coping with their symptoms, and thus do not require treatment.

The team found several strong associations between male urinary tract symptoms and long-term mortality risk.

Findings included a 20% increased risk of death among men with moderate to severe bladder emptying or “voiding” symptoms (such as hesitancy, weak stream, or straining).

There was also a 40% increase in men with “storage” symptoms (such as frequent daytime urination, nocturia, or various types of incontinence).

Analysis including mild urinary symptoms found no increase in mortality risk.

The team also found death risk was increased by 30% among men with daytime frequency and 50% for those with nocturia, regardless of symptom severity.

In addition, the risk of death was more than doubled among men with frequent urinary incontinence.

This suggests that urinary urgency has a significant impact on health and functional status in aging men—possibly reflecting the effects of long-term neurological and vascular disease.

The link between male urinary symptoms and mortality also raises questions about symptom bothersomeness in making treatment decisions.

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The research is published in The Journal of Urology and was conducted by Jonne Åkerla et al.

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