Objective: To determine the prevalence of lower urinary tract symptoms (LUTS) in systemic sclerosis (SSc), to find specific risk factors, and to assess their impact on quality of life (QoL).
Methods: In a multicenter study, 334 patients completed a self-administered questionnaire on LUTS and QoL. LUTS were classified into 3 main categories: storage, voiding, and post-micturition symptoms. Digestive symptoms burden was captured by a visual analog scale, divided into 5 equal categories. Multivariable logistic regressions were performed to test association between risk factors and LUTS categories. Linear regression adjusted the association between LUTS and QoL.
Results: LUTS were recorded in 311 SSc patients (96.0%) and classified as severe in 120 (38.0%). The storage category of LUTS was the most prevalent (91.9%), followed by voiding (72.2%) and then by post-micturition symptoms (49.8%). Risk factors identified in the multivariable models were higher than the median Health Assessment Questionnaire disability index (HAQ DI; odds ratio [OR] 4.2 [95% confidence interval (95% CI) 1.4-12.9]) in the storage category; higher than the median HAQ DI (OR 2.4 [95% CI 1.2-4.9]) for digestive symptoms burden (OR 1.9 [95% CI 1.3-2.7]) and synovitis (OR 4.8 [95% CI 1.0-22.6) in the voiding category; and higher for digestive symptoms burden (OR 1.2 [95% CI 1.0-1.5]) in the post-micturition category of symptoms. These factors also increased the odds of having further severe symptoms. QoL was affected by the 3 categories of LUTS and decreased progressively with increasing frequency of symptoms.
Conclusion: Self-reported LUTS are among the most frequent symptoms in SSc and are associated with digestive symptoms. SSc patients with LUTS have lower QoL.
Trial registration: ClinicalTrials.gov NCT01971294.
© 2017, American College of Rheumatology.