Urinary, bowel and sexual health in older men from Northern Ireland

David W. Donnelly*, Conan Donnelly, Therese Kearney, David Weller, Linda Sharp, Amy Downing, Sarah Wilding, Penny Wright, Paul Kind, James W.F. Catto, William R. Cross, Malcolm D. Mason, Eilis McCaughan, Richard Wagland, Eila Watson, Rebecca Mottram, Majorie Allen, Hugh Butcher, Luke Hounsome, Peter SelbyDyfed Huws, David H. Brewster, Emma McNair, Carol Rivas, Johana Nayoan, Mike Horton, Lauren Matheson, Adam W. Glaser, Anna Gavin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Objectives: To provide data on the prevalence of urinary, bowel and sexual dysfunction in Northern Ireland (NI), to act as a baseline for studies of prostate cancer outcomes and to aid service provision within the general population. Subjects and Methods: A cross-sectional postal survey of 10 000 men aged ≥40 years in NI was conducted and age-matched to the distribution of men living with prostate cancer. The EuroQoL five Dimensions five Levels (EQ-5D-5L) and 26-item Expanded Prostate Cancer Composite (EPIC-26) instruments were used to enable comparisons with prostate cancer outcome studies. Whilst representative of the prostate cancer survivor population, the age-distribution of the sample differs from the general population, thus data were generalised to the NI population by excluding those aged 40–59 years and applying survey weights. Results are presented as proportions reporting problems along with mean composite scores, with differences by respondent characteristics assessed using chi-squared tests, analysis of variance, and multivariable log-linear regression. Results: Amongst men aged ≥60 years, 32.8% reported sexual dysfunction, 9.3% urinary dysfunction, and 6.5% bowel dysfunction. In all, 38.1% reported at least one problem and 2.1% all three. Worse outcome was associated with increasing number of long-term conditions, low physical activity, and higher body mass index (BMI). Urinary incontinence, urinary irritation/obstruction, and sexual dysfunction increased with age; whilst urinary incontinence, bowel, and sexual dysfunction were more common among the unemployed. Conclusion: These data provide an insight into sensitive issues seldom reported by elderly men, which result in poor general health, but could be addressed given adequate service provision. The relationship between these problems, raised BMI and low physical activity offers the prospect of additional health gain by addressing public health issues such as obesity. The results provide essential contemporary population data against which outcomes for those living with prostate cancer can be compared. They will facilitate greater understanding of the true impact of specific treatments such as surgical interventions, pelvic radiation or androgen-deprivation therapy.

Original languageEnglish
Pages (from-to)845-857
Number of pages13
JournalBJU International
Volume122
Issue number5
DOIs
Publication statusPublished - Nov 2018

Bibliographical note

Funding Information:
The LAPCD study was funded by the Movember Foundation, in partnership with Prostate Cancer UK, as part of the Prostate Cancer Outcomes programme, grant number BO26/MO. The authors thank all the men who responded to the survey. We acknowledge the following people for their contribution to the development, setting up, and running of the study: Heather Kinnear, Oonagh McSorley, Victoria Cairnduff, Linda Roberts, Adrian Slater, the LAPCD User Advisory Group and Clinical and Scientific Advisory Group, Picker Institute Europe and Business Services Organisation (NI). The authors also thank Age Concern in NI for providing feedback on the survey content and layout.

Funding Information:
The LAPCD study was funded by the Movember Foundation, in partnership with Prostate Cancer UK, as part of the Prostate Cancer Outcomes programme, grant number BO26/ MO.

Publisher Copyright:
© 2018 The Authors BJU International published by John Wiley & Sons Ltd on behalf of BJU International

Keywords

  • Life After Prostate Cancer Diagnosis
  • bowel dysfunction
  • health-related quality of life
  • prostate cancer
  • sexual dysfunction
  • urinary dysfunction

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