Rural vs. urban disparities in association with lower urinary tract symptoms and benign prostatic hyperplasia in ageing men, NHANES 2001-2008

The objective of this study was to investigate rural/urban and socio-demographic disparities in lower urinary tract symptoms and benign prostatic hyperplasia (LUTS/BPH) in a nationally representative population of men.

Data on men age ≥40 years (N = 4,492) in the 2001-2008 National Health and Nutrition Examination Surveys were analysed. Self-report of physician-diagnosed enlarged prostate and/or BPH medication use defined recognised LUTS/BPH. Urinary symptoms without BPH diagnosis/medications defined unrecognised LUTS/BPH. Rural-Urban Commuting Area Codes assessed urbanisation. Unadjusted and multivariable associations (odds ratios (OR)) between LUTS/BPH and covariates were calculated using logistic regression.

Recognised and unrecognised LUTS/BPH weighted-prevalence estimates were 16. 5% and 9. 6%. There were no significant associations between LUTS/BPH and rural/urban status. Significant predisposing factors for increased adjusted odds of recognised and unrecognised LUTS/BPH included age, hypertension (OR=1. 4;1. 4), analgesic use (OR=1. 4;1. 4) and PSA level >4 ng/mL (OR=2. 3;1. 9) when adjusted for rural/urban status, race, education, income, alcohol, health insurance, health care and proton pump inhibitor (PPI) use (all p ≤ 0. 1). Restricting to urban men only (N = 3,371), healthcare use (≥4visits/year) and PPI's increased adjusted odds of recognised LUTS/BPH (OR=2. 0;1. 6); no health insurance and

Rural/urban status was not associated with significantly increased adjusted odds of either recognised or unrecognised LUTS/BPH.

International journal of clinical practice. 2015 Jul 28 [Epub ahead of print]

K B Egan, M Suh, R C Rosen, A L Burnett, X Ni, D G Wong, K T McVary

New England Research Institutes, Inc. , Watertown, MA, USA. , New England Research Institutes, Inc. , Watertown, MA, USA. , New England Research Institutes, Inc. , Watertown, MA, USA. , Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA. , Global Statistical Sciences and Advanced Analytics, Eli Lilly and Company, Indianapolis, IN, USA. , Eli Lilly and Company USA, Indianapolis, IN, USA. , Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.

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