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Global burden and temporal trends of lower urinary tract symptoms: a systematic review and meta-analysis

Prostate Cancer and Prostatic Diseases volume 26, pages 421–428 (2023)Cite this article

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Abstract

Background

Lower urinary tract symptoms (LUTS) are common complaint in urology practice and affecting the quality of life for patients. This article aims to perform a systematic review and meta-analysis on the global prevalence of LUTS overall, and according to different patient characteristics.

Methods

We searched MEDLINE and Embase for population-based epidemiological studies reporting the prevalence of LUTS from inception to 1 Jan 2021. Studies which: (1) have enough information on sample size and prevalence; (2) investigate individuals aged 15 or above; and (3) have clear diagnostic criteria for LUTS. We extracted the following information: year of publication; name of the first author; study period; region of recruitment; race; age range; sex; severity; symptoms; and criteria. We pooled rate estimates with exact binomial and test score-based confidence intervals (CIs) using proportions with a random-effects model.

Results

We included 222 studies from 36 countries involving 1,692,110 samples and 632,933 patients with LUTS. The overall prevalence of any and moderate-to-severe LUTS was 63.2% (95% CI = 58.0–68.1) and 31.3% (95% CI = 28.8–33.8), respectively. The most common symptom was storage symptoms (56.7%; 95% CI = 51.0–62.4), followed by voiding symptoms (36.4%; 95% CI = 27.8–45.4) and post-micturition symptoms (30.7%; 95% CI = 19.2–43.6). A higher prevalence of moderate-to-severe LUTS was observed in male subjects (35.2%; 95% CI = 32.1–38.5) and individuals aged ≥60 (39.0%; 95% CI = 33.4–44.8; I2 = 99.9%). Its prevalence increased from 27.4% (95% CI = 24.5–30.3) in 1990–1999, to 31.9% (95% CI = 27.3–36.7) in 2000–2009 and 36.2% (95% CI = 30.7–41.9) in 2010–2019.

Conclusions

This study was the first comprehensive meta-analysis examining the global prevalence of LUTS. We identified a high level of LUTS prevalence in the general population, with a higher burden in male subjects, older individuals, and the Asian population. There has been an increasing trend in the prevalence of LUTS since the 1990s.

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Fig. 1: PRISMA flow diagram for study.
Fig. 2: Prevalence of LUTS by severity, symptom, and criteria.
Fig. 3: Prevalence of moderate-to-severe LUTS by demographics.
Fig. 4: Prevalence of moderate-to-severe LUTS in individuals aged ≥40 years.
Fig. 5: Global prevalence of moderate-to-severe LUTS in males aged ≥40 years.

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Data availability

The data used for the analyses are available upon reasonable request from the corresponding authors.

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Author information

Authors and Affiliations

  1. Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China

    Junjie Huang, Yunyang Deng, Yijun Bai, Sze Chai Chan, Man Sing Tin & Martin C. S. Wong

  2. Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China

    Junjie Huang & Martin C. S. Wong

  3. S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China

    Chi-Kwok Chan, Samuel Yee, Jeremy Yuen-Chun Teoh & Chi-Fai Ng

  4. Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands

    Xianjing Liu

  5. Department of Global Public Health, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden

    Veeleah Lok

  6. School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China

    Lin Zhang & Martin C. S. Wong

  7. School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia

    Lin Zhang

  8. School of Public Health, Fudan University, Shanghai, China

    Wanghong Xu

  9. Department of Global Health, School of Public Health, Peking University, Beijing, China

    Zhi-Jie Zheng & Martin C. S. Wong

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Contributions

MCSW and CFN participated in conceiving the study and project administration. YD, YB, MST, and JH contributed to the data search and curation. JH conducted statistical analyses. JH and SCC drafted the manuscript. CFN, CKC, SY, XL, VL, LZ, WX, ZJZ, JYCT, and MCSW critically reviewed and revised the manuscript. JH is the correspondence during journal submission.

Corresponding authors

Correspondence to Chi-Fai Ng or Martin C. S. Wong.

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Huang, J., Chan, CK., Yee, S. et al. Global burden and temporal trends of lower urinary tract symptoms: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 26, 421–428 (2023). https://doi.org/10.1038/s41391-022-00610-w

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