Prevalence of hesitancy in 30-80-year-old Finnish men: Tampere Ageing Male Urological Study (TAMUS).

Abstract

Study Type--Therapy (symptom prevalence). Level of Evidence 2a. What's known on the subject? and What does the study add? In several population-based studies the prevalence of hesitancy has varied from 20% to 52%. Studies concern mostly older men ≥50-years-old. Knowledge of troublesomeness that hesitancy causes is very scarce. This is a large population-based study on hesitancy in men with a wide age range. This study reports the prevalence of hesitancy from 30-year-old men to 80-year-old men. The bother of hesitancy is reported and this is also presented in different age groups. • To estimate the prevalence and bother of hesitancy by age group. • In this population-based study, the target population was 30- to 80-year-old men from Pirkanmaa County, Finland. • Information was collected by means of a mailed self-administered questionnaire in 2004. The overall participation proportion was 58.7% (4384 men out of 7470). • The Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire was used to evaluate urinary symptoms, particularly hesitancy. Logistic regression was used for multivariate analysis. • Almost half of the men (46.8%, 95% CI 45.3-48.3%) reported hesitancy at least occasionally, but only 0.5% (95% CI 0.3-0.7%) had hesitancy every time they urinated. The prevalence of any hesitancy was 42.3% at 30 years and 50.5% at 80 years of age (trend P < 0.001). Only a few men reported hesitancy often or always, prevalence increasing with age from 2.6% to 11.4% (trend P < 0.001). • Hesitancy caused a small problem for 18.3% of the men and a moderate or major problem for 0.9-5.3%. Only 3% of the men with infrequent hesitancy reported more than a small problem, whereas 59% of the men with hesitancy often or always reported a small problem and 32% reported a moderate or major problem. • Two other voiding symptoms, straining and weak stream, were strongly associated with hesitancy (with odds ratios exceeding 80). • Mild hesitancy is very common in men of all ages. • Severe cases are rare, but the prevalence increases with age. • Hesitancy is a well-tolerated urinary symptom.