Symptom Bother Is Associated With Medical Care-Seeking for LUTS in Japanese Women: A Survey of 1800 Women.

BACKGROUND AND OBJECTIVE: Lower urinary tract symptoms (LUTS) are highly prevalent in women, yet care-seeking is very low, and a large treatment gap remains despite the availability of effective treatments. Previous studies, mainly from Western populations, suggest that symptom bother, as well as symptom severity, is associated with medical care-seeking; however, quantitative data in Asian and particularly Japanese women are scarce, the influence of bother on the separate care indicators is unclear, and the willingness to pay (WTP) for treatment has rarely been quantified. We therefore examined the factors associated with medical care-seeking, including symptom bother, and the WTP, in Japanese women. METHODS: We conducted a nationwide web-based survey of 1800 Japanese women aged 40 years or older, covering the OABSS, ICIQ-UI SF, symptom bother (0-10), separate care indicators (consulting, visiting, treatment, and current treatment), reasons for not seeking care, and WTP. Factors associated with visiting a clinic were assessed with multivariable logistic regression. RESULTS: Among symptomatic women, only 12.9% had visited a clinic. Both symptom bother and measured symptom severity were independently associated with visiting (bother ≥ 5, adjusted OR 5.19, 95% CI 3.08-8.76; OABSS ≥ 6, adjusted OR 2.24, 95% CI 1.23-4.07), while age, marital status, children, housing, and income were not significant. The most common reason for not seeking care was "thought it was just aging" (65.1%), and WTP rose with bother. CONCLUSIONS: In Japanese women, symptom bother was independently associated with medical care-seeking (visiting a clinic) for LUTS, as was symptom-score severity.