Natural course of lower urinary tract symptoms in men not requiring treatment - A 5-year longitudinal population-based study

Objective To evaluate the natural course of lower urinary tract symptoms (LUTS) by quantifying their longitudinal changes. Methods A population-based study of men aged 55, 65, or 75 years in Pirkanmaa region, Finland was conducted with a 5-year follow-up (1999-2004). Mailed self-administered questionnaire with the Danish Prostatic Symptom Score instrument was used to evaluate LUTS. Men with any treatment for LUTS or a history of prostate cancer were excluded. Results A total of 1331 men were included in the study. All 12 symptoms exhibited considerable fluctuation over time. Incidence of specific symptoms varied by a factor of 10 and remission by a factor of 4. Overall, common symptoms varied most strongly in terms of incidence and remission, whereas the less common ones such as incontinence behaved in a more stable fashion. Remission was more frequent than incidence for all individual LUTS components. The highest incidence was found for post-micturition symptoms and urgency. Remission was most common in weak stream and least frequent in urgency and urgency incontinence. Conclusion LUTS are dynamic conditions with strong spontaneous fluctuation over time. Remission was more common than incidence. The strong propensity for spontaneous resolution should also be borne in mind in treatment decisions including prescription practices.