Systemic health patterns associated with nocturia and urgency urinary incontinence in US men

Abstract Nocturia and urgency urinary incontinence (UUI) are readily elicited storage symptoms, but whether their systemic health associations reflect symptom number, composition, or both is uncertain. We analyzed seven NHANES cycles (2005–2018) with mortality follow-up through 2019. Among 11,236 men aged ≥ 40 years, weighted prevalence was 25.6% for nocturia only, 3.2% for UUI only, and 5.1% for both symptoms. In survey-weighted models, nocturia only was associated with advanced cardiovascular-kidney-metabolic (CKM) status (OR 1.58, 95% CI 1.14–2.18), whereas both symptoms were associated with low cardiovascular health (CVH) (OR 3.25, 95% CI 1.86–5.69). UUI only showed no dominant CKM/CVH pattern. Health burden increased with symptom number; two symptoms were associated with severe functional limitation (OR 3.82), depressive symptoms (OR 5.45), and all-cause mortality (HR 1.73, 95% CI 1.44–2.07). Compared with either single-symptom group, both symptoms were associated with greater functional, psychological, multimorbidity, and mortality burden; polypharmacy did not clearly differ. Interactions and single-symptom comparisons showed no clear differences. The associations reflected both dimensions: symptom count identified the breadth of health vulnerability, whereas composition distinguished systemic context. This classification may help prioritize multidomain assessment when both symptoms coexist, with CKM evaluation for nocturia only and CVH evaluation for coexisting symptoms.