Lower urinary tract symptoms in men: challenges to early hospital presentation in a resource-poor health system
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RESEARCH ARTICLE
Open Access
Lower urinary tract symptoms in men: challenges to early hospital presentation in a resource-poor health system Ikenna I. Nnabugwu1* , Ijeoma L. Okoronkwo2 and Chinwe A. Nnabugwu2
Abstract Background: The point at which men seek medical care for lower urinary tract symptoms (LUTS) varies between individuals. Presentation to hospital with complications beyond LUTS appears prevalent in our setting. The aim of this survey is to assess from the community perspective in southeast Nigeria, the challenges to early presentation for medical evaluation for LUTS by men. Methods: A questionnaire-based cross-sectional survey of randomly-selected men ≥40 years. The questionnaire captured respondent’s age; presence, duration and severity of LUTS; access to health information; wealth-index; and when (and why) medical care for LUTS was sought. Analysis was with SPSS® version 20. Results: In all, responses from 1319 men (mean age 54.2 ± 10.2 years) are analysed. Of these, 267 report LUTS: 58.4% (156) report moderate to severe LUTS and 51.7% (138) are yet to seek medical care. As regards seeking medical care, all the men reporting LUTS of 3 months, 35.7% of 126 men reporting moderate LUTS, and 20.0% of 30 men reporting severe LUTS are yet to seek medical care. LUTS being non-bothersome (not financial constraint) is the most prevalent reason for not seeking medical care early. Delay is encouraged by limited access to health information (OR 3.10; p < 0.001), but discouraged by literacy (OR 0.86; p < 0.001) and aging (OR 0.93; p = 0.002). Conclusion: From the community perspective, the prevalent challenge to seeking medical care for LUTS early is absence of bother. Empowering men through formal education and researched health information will influence positively the time that LUTS in men is appreciated as bothersome. Keywords: LUTS, Men, Medical-care, Challenges, Delay
Background Lower urinary tract symptoms (LUTS) are a set of symptoms that usually indicate that there is dysfunction in the storage and controlled evacuation of urine from the urinary bladder [1]. These symptoms can occur in any age group, but the reasons for the symptoms vary from age to age and from one gender to the other [2]. Irrespective of the primary diagnosis, it is suspected * Correspondence: [email protected] 1 Department of Surgery, College of Medicine, University of Nigeria Ituku-Ozalla, Enugu PMB 01129, Nigeria Full list of author information is available at the end of the article
that LUTS could have a common pathway [3]. The occurrence of any or some of these symptoms is an indication that there is altered bladder compliance, altered infravesical resistance, increased flow of urine into the bladder, or a combination of these in varying proportions [4]. LUTS may vary from sudden onset transient LUTS, to insidious onset progressive LUTS [5]. In men who are 40 years of age and older, common disease conditions associated with insidious onset progressive LUTS include enlarging benign and malignant prostates, chronic pr
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