Prevalence and severity of lower urinary tract symptoms (LUTS) according to male sexual orientation remains poorly investigated. In a recent study published in Nature Prostate Cancer and Prostatic Diseases , a team of researchers found that ‘men who have sex with men’ (MSM) have a significantly higher prevalence of LUTS when compared with heterosexual individuals.
Estimates indicate the prevalence of the gay/homosexual or bisexual male population in the United States (US) to be ~4% and 1%, respectively, however a large number of men engage in sex with other men without reporting either gay or bisexual orientation. These men, are usually termed as ‘men who have sex with men’ (MSM), with studies indicating that they are at an increased risk of poorer health because of an array of social and behavioural factors. MSM are more frequently diagnosed with sexually transmitted infections (STIs) compared with the general population, with a concomitant higher incidence of STI-related diseases.
Lower urinary tract symptoms (LUTS) are a major cause of morbidity and discomfort in the male population, mainly because of Benign prostatic hyperplasia (BPH), an enlarged prostate gland (LUTS/BPH).
In the study entitled “Lower urinary tract symptoms among Caucasian-European men who have sex with men: findings from a real-life survey”, Professor A. Salonia from the Division of Experimental Oncology/Unit of Urology, University Vita-Salute San Raffaele in Milan and colleagues hypothesized that the real-life rates and severity of LUTS could vary according to sexual orientation, and investigated this hypothesis using validated psychometric scales in a cohort of 949 Caucasian-European men seeking first medical help for uroandrologic purposes other than LUTS at a single academic outpatient clinic.
Patients completed the International Prostate Symptom Score (IPSS) measuring their subjective perception of LUTS, with scores 1–3 and > 4 (of 15), and voiding symptoms scores 1–4 and >5 (of 20) representing mild, to moderate- severe symptoms, respectively.
A total of 213 (22.4%) men who have sex with men (MSM) and 736 (77.6%) heterosexuals were examined. The results revealed that in comparison with heterosexuals, MSM reported higher rates of total IPSS scores of moderate LUTS (21.6% versus 20%) and severe LUTS (3.8% versus 2.4%). The researchers also found that MSM had higher rates of mild (48.8% versus 45.2%) and moderate-to-severe (39.4% versus 30.4%) storage symptoms and of mild (45.1% versus 34.8%) and moderate-to-severe (20.2% versus 19.2%) voiding symptoms, when compared to heterosexual men.
Results from the logistic regression analysis showed that the MSM status was predictor of mild voiding symptoms, moderate-to-severe storage symptoms and severe total IPSS. “Our findings provide new clinically relevant evidence that MSM have a significantly higher prevalence of LUTS compared with heterosexual individuals in a cohort of age-comparable Caucasian-European men not specifically seeking medical help for LUTS.”, the researchers concluded.