Associations of pain in young men presenting with lower urinary tract symptoms.

Introduction: This study analyzes clinical associations of pain in young men presenting with a primary complaint of a lower urinary tract symptom (LUTS). Methods: A secondary analysis of the SciCOM 3 study examining young men presenting with LUTS was performed. Bladder pain was recorded by Q4 of the Interstitial Cystitis Symptom Score, while nonbladder pain was captured by the Visual Analog Scale. LUTS, sexual dysfunction, stool consistency, perception of problems related to the bladder, and general well-being were captured by questionnaires. Results: A total of 448 young men (18-40 years; median 30 years, interquartile range: 25-35 years) were studied across 16 centers. Eighty-seven (19.8%) reported no pain (Group 1), 143 (32.6%) bladder pain alone (Group 2), 39 (8.9%) only nonbladder pain (Group 3), and 170 (38.7%) both bladder and nonbladder pain (Group 4). Men in Group 4 were more likely to report reduced strength of stream (odds ratio [OR] 1.95; 95% confidence interval [CI]: 1.27 and 3.01), need to stop and start (OR 1.81; 95% CI: 1.19 and 2.74), sense of incomplete evacuation (OR: 2.64; 95% CI: 1.58 and 4.40), and urgency (OR: 1.73; 95% CI: 1.16 and 2.59), while men in Group 2 were more likely to report urine leak for no apparent reason (OR: 1.85; 95% CI: 1.17 and 2.90). Group 1 was the least likely to report an abnormal sense of well-being. Conclusions: Pain is commonly reported by young men presenting with LUTS. The pattern of pain in LUTS is associated with a distinct clinical epidemiology, including both storage and voiding LUTS, with an impact on bother and quality of life. It is important to assess pain in young men presenting with LUTS.