Contribution of Common Medications to Lower Urinary Tract Symptoms in Men

While benign prostatic hyperplasia (BPH) is the commonest cause, the etiology of lower urinary tract symptoms (LUTS) is multifactorial. BPH clinical guidelines suggest evaluating other potential sources of LUTS (e.g., concomitant medication use) before initiating pharmacotherapy or surgical intervention.1 Through effects on detrusor muscle and urinary sphincter function, several categories of prescription drugs can worsen LUTS,2,3 including antidepressants, antihistamines, bronchodilators, anticholinergics and sympathomimetics.4 By increasing urine volume, diuretics are also associated with LUTS.5,6 Because their prevalence of use rises with patient age, prescription drugs may contribute to the age-related increase in LUTS.7,8 Most previous research has focused on LUTS overall, without accounting for heterogeneity in etiology. If a significant proportion of LUTS can be attributed to medication use, the observed association between a suspected risk factor and LUTS could be attenuated. Thus, it is important to determine the magnitude of the association between medications and LUTS, and the degree to which LUTS may be attributed to these medications. To this end, this study assesses the cross-sectional association between current use of selected common medications and LUTS among men enrolled in the California Men's Health Study (CMHS).