Age- and Sex-Specific Prevalence of Lower Urinary Tract Symptoms in Pediatric and Young Adults in a Swedish National Cohort

BackgroundLower Urinary Tract Symptoms (LUTS significantly impact quality of life and are prevalent across life course. Despite their importance, population-based incidence rates for pediatric and young adult populations, including age and sex-specific differences, remain poorly quantified. MethodsWe analyzed data from all live-born children in Sweden between 1995 and 2005, with follow-up through 2018, extracted from the Swedish National Medical Birth Register. We employed three distinct methods to identify LUTS cases: (1) an ICD-10 diagnostic code approach, (2) a broad ICD-medication approach that includes ICD-10 diagnosis or at least one prescription of LUTS-related medications (anticholinergics, Alfa-1-receptor antagonist, or Beta-3 receptor agonists), and (3) a narrow ICD-medication approach that includes an ICD-10 diagnosis or multiple prescriptions over a specified timeframe. We analyzed sex-specific (sex assigned at birth) and age-specific incidence rates per 100,000 person-years in individuals younger than 24. FindingsThe cohort included 982,903 individuals, 0.1% diagnosed with storage and voiding LUTS based on ICD-10 diagnostic code. Under the broad ICD-medication definition, 0.9% had storage LUTS, and 0.2% had voiding LUTS; the narrow ICD-medication definition identified 0.5% with storage LUTS and 0.1% with voiding LUTS. Notably, females were diagnosed at older ages. ConclusionsThis study reveals an underestimation of LUTS prevalence when relying solely on ICD-10 diagnostic codes. Broader diagnostic criteria uncover higher prevalences and demonstrate varied detection rates and ages at diagnosis by sex. These findings underscore the necessity for more inclusive diagnostic approaches in epidemiological research to capture and understand the full scope of LUTS accurately.