Revisiting the Spectrum of Bladder Health: Relationships between Lower Urinary Tract Symptoms and Multiple Measures of Well-Being

Siobhan Sutcliffe, Charles Cain, Tamara Bavendam, C. Neill Epperson, Colleen M. Fitzgerald, Sheila Gahagan, Alayne D. Markland, David A. Shoham, Ariana L. Smith, Kyle Rudser

Research output: Contribution to journalArticlepeer-review


Little research to date has investigated the spectrum of bladder health in women, including both bladder function and well-being. Therefore, we expanded our previous baseline analysis of bladder health in the Boston Area Community Health (BACH) Survey to incorporate several additional measures of bladder-related well-being collected at the 5-year follow-up interview, including one developed specifically for women. Methods: At follow-up, participants reported their frequency of 15 lower urinary tract symptoms (LUTS), degree of life impact from and thought related to urinary symptoms or pelvic/bladder pain/discomfort, and perception of their bladder condition. Prevalence ratios were calculated by generalized linear models with robust variance estimation, adjusting for LUTS risk factors and individual LUTS. The BACH Survey was approved by the New England Research Institutes Institutional Review Board and all participants provided written informed consent. Results: Generally similar findings were observed in the 5-year cross-sectional analysis as at baseline, irrespective of how we categorized LUTS or measured bladder-related well-being. Approximately one in five women (16.2%-18.0% of 2527 eligible women) reported no LUTS and no diminished bladder-related well-being, the majority (55.8%-65.7%) reported some LUTS and/or diminished well-being, and a further one in five (16.9%-26.6%) reported the maximum frequency, number, or degree of LUTS and/or diminished well-being. Measures of storage function (urinating again after <2 hours, perceived frequency, nocturia, incontinence, and urgency) and pain were independently associated with bladder-related well-being. Conclusions: Our similar distribution of bladder health and consistent associations between LUTS and bladder-related well-being across multiple measures of well-being, including a female-specific measure, lend confidence to the concept of a bladder health spectrum and reinforce the bothersome nature of storage dysfunction and pain.

Original languageEnglish (US)
Pages (from-to)1077-1090
Number of pages14
JournalJournal of Women's Health
Issue number8
StatePublished - Aug 2020

Bibliographical note

Funding Information:
This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health (NIH) by cooperative agreements (Grants U01DK106786, U01 DK106853, U01 DK106858, U01 DK106898, U01 DK106893, U01 DK106827, U01 DK106908, and U01 DK106892). Additional funding was from National Institute on Aging, NIH Office on Research in Women’s Health and the NIH Office of Behavioral and Social Science.

Publisher Copyright:
© Copyright 2020, Mary Ann Liebert, Inc., publishers 2020.


  • bladder
  • health
  • women

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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