PD06-09: Relationships Between Longitudinal Urinary Symptoms and Physical and Psychosocial Factors in Women in the Symptoms of Lower Urinary Tract Dysfunction Research Network

Abigail R. Smith*, Sarah A. Mansfield, Ann Arbor, MI, Catherine S. Bradley, Iowa City, IA, Kimberly Kenton, Chicago, IL, Margaret Helmuth, Anne P. Cameron, Ann Arbor, MI, Ziya Kirkali, Bethesda, MD, C. Emi Bretschneider, Chicago, IL, Victor Andreev, Aruna Sarma, Giulia Lane, Ann Arbor, MI, Sarah Collins, David Cella, Chicago, IL, H. Henry Lai, St. Louis, MO, Kathryn E. Flynn, Milwaukee, WI, Steve Harte, Ann Arbor, MI, James W. Griffith, Chicago, IL

Introduction: Physical and psychological health, including sleep disturbance and depression, represent potentially modifiable factors in the causal pathway of lower urinary tract symptom (LUTS) severity. The objective of this analysis was to understand the relationship between baseline physical and psychological factors and LUTS over 12 months.

Methods: Adult women seeking care for LUTS were enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) observational cohort study. Urinary symptoms were assessed using the LUTS Tool and PFDI at baseline, 3, and 12 months. LUTS Tool items representing common symptom domains were combined using weighted Euclidian length. Physical functioning, depression, and sleep disturbance were measured using PROMIS questionnaires, and relationships were assessed using multivariable linear mixed effects regression models adjusted for clinical variables.

Results: Of 545 women enrolled in LURN, 472 had follow-up at 3 and/or 12 months and were included in this analysis. Median age was 57 years, 83% were White, and 47% were obese. PROMIS depression scores were positively associated with all urinary outcomes (range 2.5-4.8 unit increase per 10 unit increase in depression score, p<0.01, Figure). Higher sleep disturbance scores were associated with higher urgency, obstructive, and total LUTS severity scores as well as UDI and total PFDI (1.9-3.6 point increase in urinary symptoms per 10-unit increase, all p<0.02), but not SUI severity, POPDI or CRADI scores. Higher PROMIS physical functioning scores were associated with lower scores on all urinary symptom measures except SUI (2.3-5.2 point decrease per 10-unit increase, all p<0.01). Higher BMI and current or former smoking status were associated with higher SUI severity scores, while older age was associated with lower UDI and POPDI scores. All symptom scores were lower at 3 and 12 months compared to baseline.

Conclusions: Physical and psychological factors demonstrated mild to moderate associations with urinary symptom domains. Further work is need to determine whether interventions targeting these non-urologic factors might reduce LUTS in women.

Source of Funding: This study is supported by the National Institute of Diabetes & Digestive & Kidney Diseases through cooperative agreements (grants DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK099879).