Abstract
INTRODUCTION: A study was performed to determine the most common and most bothersome symptoms and clinical associations in young men (18-40 years) presenting with lower urinary tract symptoms (LUTS). METHODS: Cross-sectional study was conducted across 16 centers. Urinary symptoms, impact of bladder problems, bowel symptoms, erectile dysfunction, premature ejaculation, bladder pain, non-bladder myofascial pain, and general well-being were assessed by validated questionnaires. RESULTS: A total of 448 men (median age 30 years) were included. Nocturia ≥1 (89.1%) and feeling of incomplete bladder evacuation (76.6%) were the most common symptoms while the most bothersome symptoms were daytime frequency and nocturia (median score 5; interquartile range 2-8, for both) on the International Consultation on Incontinence Questionnaire for Male LUTS questionnaire. Bladder symptoms were associated with severe or many severe problems (response 5 or 6, on the Patient Perception of Bladder Conditions Questionnaire) in 17.8% of the patients. Men between 18 and 20 years reported greater bother with their bladder condition. Normal erections and "very good" control over ejaculation were reported by 49.8% and 15.6%, respectively. Constipation and loose stools were reported by 22.8% and 12.9%, while bladder pain and non-bladder myofascial pain were reported by 72.5%, and 48.2%, respectively. 17.0% of the patients reported low scores on the WHO-5 Well-Being Scale. Two distinct patient clusters were identified. A larger cluster (63.9%) that presented with voiding symptoms and urgency but fewer sexual or pain symptoms, and a smaller cluster that showed pronounced sexual symptoms, pain, daytime frequency, and nocturia. CONCLUSIONS: The most common urinary symptoms in young men are nocturia and a sense of incomplete evacuation. Daytime frequency and nocturia are the most bothersome symptoms. It is important to assess associated symptoms in young men presenting with LUTS.