Lived Experiences of Emotional Distress Among Patients With Lower Urinary Tract Symptoms: A Mixed-Methods Study.

PURPOSE: We aimed to describe the association of lower urinary tract symptoms (LUTS) with emotional distress using questionnaires and qualitative interviews.

METHODS

We used a convergent parallel mixed methods design to examine relationships between the LURN Symptom Index-29 (LURN SI-29) questionnaire and emotional distress, measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety and Depression Short Forms and the Perceived Stress Scale. Quantitative analyses assessed correlations between the SI-29 total and subscale scores and emotional distress measures. Qualitative interviews explored the emotional impact of LUTS, with representative quotations used to contextualize quantitative findings.

RESULTS

The total and pain subscale scores of the LURN SI-29 demonstrated the strongest positive correlations with anxiety (r = 0.25-0.33), depression (r = 0.24-0.30), and stress (r = 0.21-0.28). Urgency, incontinence and voiding subscales had weaker associations, while nocturia showed minimal or slighting negative correlations (|r| < 0.12). Although most of the relationships were statistically significant, effect sizes were generally small. Qualitative narratives converged with these findings, describing how pain, unpredictability, and loss of control contributed to anxiety, depression, and stress.

CONCLUSIONS

Pain and overall LUTS burden were the primary contributors to emotional distress, whereas nocturia played a minimal role. Despite cohort selection for urinary urgency, pain was a driver of emotional distress, highlighting the need to assess bladder-related pain and its psychosocial impacts in LUTS care.

TRIAL REGISTRATION: NCT02485808.