Urinary, bowel and sexual health in older men from Northern Ireland

OBJECTIVES: To provide intelligence on the prevalence of urinary, bowel and sexual dysfunction in Northern Ireland (NI) to act as a baseline for studies of prostate cancer (PCa) outcomes and to aid service provision within the general population. SUBJECTS AND METHODS: A cross-sectional postal survey of 10,000 men aged 40 and over in NI, age-matched to the distribution of men living with PCa. The EQ-5D-5L and EPIC-26 instruments were used to enable comparisons with PCa outcome studies. While representative of the PCa survivor population, the age-distribution of the sample differs from the general population, thus data were generalised to the NI population by excluding 40-59 year olds and applying survey weights. Results are presented as proportions reporting problems along with mean composite scores, with differences by respondent characteristics assessed using chi-square tests, ANOVA and multivariable log-linear regression. RESULTS: Among men aged 60 plus, 32.8% reported sexual dysfunction, 9.3% urinary dysfunction and 6.5% bowel dysfunction. 38.1% reported at least one problem and 2.1% all three. Worse outcome was associated with increasing number of long-term conditions, low physical activity, and higher BMI. Urinary incontinence, urinary irritation/obstruction, and sexual dysfunction increased with age; while urinary incontinence, bowel, and sexual dysfunction were more common among the unemployed. CONCLUSION: These data provide an insight into sensitive issues seldom reported by elderly men, which result in poor general health, but could be addressed given adequate service provision. The relationship between these problems, raised BMI and low physical activity offers the prospect of additional health gain by addressing public health issues such as obesity. The results provide essential contemporary population data against which outcomes for those living with PCa can be compared. They will facilitate greater understanding of the true impact of specific treatments such as surgical interventions, pelvic radiation or androgen deprivation therapy.