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Lower urinary tract symptoms in men: self-perceptions and the concept of bother

Gannon, Kenneth; Glover, Lesley; O'Neill, Marie; Emberton, Mark


Kenneth Gannon

Lesley Glover

Marie O'Neill

Mark Emberton


OBJECTIVE To explore the meaning that men attach to their experiences of having lower urinary tract symptoms (LUTS) and to understand 'bother' in the context of those meanings. PATIENTS AND METHODS Sixteen men with symptoms suggestive of LUTS and/or an enlarged prostate were recruited from the outpatient urologyclinic of a London teaching hospital. They were assessed before or shortly after their first appointment, during which demographic information, including age, occupation, marital status and ethnicity, was obtained and an individualized repertory grid was completed. Each man also completed the International Prostate Symptom Score, which included an item measuring overall bother, and the Hospital Anxiety and Depression Scale. RESULTS Most participants held very negative views about what it meant to have prostate problems and viewed them as being associated with old age. Nevertheless, they also had reasonably high levels of self-esteem. However, there was evidence that these had been higher before they had prostate problems, and that self-esteem might decline over time. Bother was related to symptom scores and to anxiety. Also, a perception that other people, particularly their partner, saw them in a more negative light because of their symptoms was associated with higher levels of bother. CONCLUSIONS The findings suggest that men attempt to preserve a sense of a relatively youthful and intact 'self in the face of advancing years and a progressive disease that was viewed as being associated with old age. Overall, these men had a reasonably secure self-image and they deployed a range of cognitive strategies to maintain this. Bother appears to be a combination of symptom severity, psychological distress, negative evaluations of the condition and beliefs about the reactions of others. Reducing anxiety and challenging negative stereotypes and expectations that others would view them negatively if their problems were known might reduce bother. Attending to these factors could enable watchful waiting to be optimized by reducing bother. Trials to evaluate interventions drawing on these principles would be valuable.


Gannon, K., Glover, L., O'Neill, M., & Emberton, M. (2005). Lower urinary tract symptoms in men: self-perceptions and the concept of bother. BJU international, 96(6), 823-827.

Journal Article Type Article
Acceptance Date May 6, 2005
Online Publication Date Sep 9, 2005
Publication Date 2005-10
Print ISSN 1464-4096
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 96
Issue 6
Pages 823-827
Keywords Urology; LUTS; Bother; Psychology; Personal constructs
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