Lower Urinary Tract Symptoms, Depression and Sleep Problems; A Triple Whammy for Patients’ Health-related Quality of Life

Introduction: Lower urinary tract symptoms (LUTS) are characterized by voiding, storage and post-micturition symptoms. LUTS can have detrimental effects on various facets of patients’ quality of life. Therefore, this study was aimed to evaluate the association of LUTS with depression and sleep disturbances, and their impact on patients’ health-related quality of life (HRQOL). Methods: A cross-sectional survey was conducted among a clinical sample of calcium channel blocker-users (n = 410), recruited via convenient sampling. Outcomes were assessed using validated Urdu translated instruments [LUTS: International Prostate Symptom Score; sleep problems: Jenkins sleep evaluation questionnaire (JSEQ); depression: Center for Epidemiologic Studies Short Depression Scale (CESD-10); HRQOL: EQ-5D-3L scale]. SPSS version 22 was used for data analysis. Results: Median CESD score was 12 (quartiles: 8, 15), with 67.6% of the patients suspected to be depressive. In multivariate analysis, an increasing severity of LUTS (p < 0.001), poor sleep (p = 0.010) and cardiovascular disease (p = 0.027) were associated with depression. Median JSEQ score was 9.50 (quartiles: 5, 12), with 32.7% of patients reporting frequent sleep disturbances (JSEQ ≥12). In multivariate analysis, increasing severity of LUTS, cardiovascular disease, and depression were linked with sleep problems. Median EQ-5D and VAS scores were 0.620 (quartiles: 0.128, 0.796) and 60 (quartiles: 50, 75), respectively. Only 13% of patients did not report any problems (health state: 11111) in all the five dimensions of the EQ-5D. LUTS along with depression, sleep problems, and cardiovascular disease had a significant adverse impact on patients’ HRQOL. Conclusion: LUTS are related to significant sleep problems, depression, and a decline in the HRQOL of patients. Individuals should be informed that these symptoms are not normal consequences of aging, but rather warrant medical attention.