Table 1.
Association of mental health diagnostic category with lower urinary tract symptoms among 519,189 Iraq and Afghanistan male veterans in veterans affairs health care from 2001–2010
| Any LUTS Diagnoses, Related Procedure, or Prescription (n = 519,189) | ||||
|---|---|---|---|---|
| Total (n = 519,189) |
No LUTS Outcome (n = 507,952) |
Any LUTS Outcome† (n = 11,237) |
||
| No. | No. (%) | No. (%) | RR (95% CI) | |
| Demographics | ||||
| Gender | ||||
| Female | 62,849 | 60,844 (96.8) | 2005 (3.2) | |
| Male | 456,340 | 447,108 (98.0) | 9232 (2.0) | 0.63 (0.60–0.67)*** |
| Age | ||||
| 18–24 | 142,899 | 141,136 (98.8) | 1763 (1.2) | |
| 25–34 | 200,397 | 197,139 (98.4) | 3258 (1.6) | 1.32 (1.24–1.40)*** |
| 35–44 | 114,965 | 112,012 (97.4) | 2953 (2.6) | 2.08 (1.96–2.21)*** |
| 45–54 | 51,226 | 48,850 (95.4) | 2376 (4.6) | 3.76 (3.54–4.00)*** |
| 55–64 | 9702 | 8815 (90.9) | 887 (9.1) | 7.41 (6.85–8.01)*** |
| Race and/or ethnicity | ||||
| Non-white | 277,098 | 270,871 (97.8) | 6227 (2.2) | |
| White | 242,091 | 237,081 (97.9) | 5010 (2.1) | 0.92 (0.89–0.96)*** |
| Marital status | ||||
| Married | 234,065 | 227,797 (97.3) | 6268 (2.7) | |
| Never married | 260,864 | 256,795 (98.4) | 4069 (1.6) | 0.58 (0.56–0.61)*** |
| Divorced, widowed, or other | 24,260 | 23,360 (96.3) | 900 (3.7) | 1.39 (1.29–1.48)*** |
| Residence | ||||
| Rural | 192,466 | 188,069 (97.7) | 4397 (2.3) | |
| Urban or suburban | 310,648 | 303,944 (97.8) | 6704 (2.2) | 0.94 (0.91–0.98)** |
| Military service | ||||
| Military branch | ||||
| Army | 315,739 | 308,389 (97.7) | 7350 (2.3) | |
| Air Force | 62,080 | 60,682 (97.7) | 1398 (2.3) | 0.97 (0.91–1.02) |
| Marines | 73,090 | 72,088 (98.6) | 1002 (1.4) | 0.59 (0.55–0.63)*** |
| Navy | 68,280 | 66,793 (97.8) | 1487 (2.2) | 0.94 (0.89–0.99)** |
| Military component | ||||
| Active duty | 299,351 | 293,794 (98.1) | 5557 (1.9) | |
| Reserve/National Guard | 219,838 | 214,158 (97.4) | 5680 (2.6) | 1.39 (1.34–1.44)*** |
| Military rank | ||||
| Enlisted | 475,415 | 465,280 (97.9) | 10,135 (2.1) | |
| Officer | 43,774 | 42,672 (97.5) | 1102 (2.5) | 1.18 (1.11–1.26)*** |
| Number of deployments | ||||
| Single deployment | 333,245 | 326,033 (97.8) | 7212 (2.2) | |
| Multiple deployment | 185,944 | 181,919 (97.8) | 4025 (2.2) | 1.00 (0.96–1.04) |
| Other health problems and medications | ||||
| Depression | ||||
| No | 404,009 | 397,702 (98.4) | 6307 (1.6) | |
| Yes | 115,180 | 110,250 (95.7) | 4930 (4.3) | 2.74 (2.64–2.84)*** |
| PTSD | ||||
| No | 382,435 | 376,043 (98.3) | 6392 (1.7) | |
| Yes | 136,754 | 131,909 (96.5) | 4845 (3.5) | 2.12 (2.04–2.20)*** |
| Diabetes | ||||
| No | 510,641 | 499,955 (97.9) | 10,686 (2.1) | |
| Yes | 8548 | 7997 (93.6) | 551 (6.4) | 3.08 (2.84–3.35)*** |
| Hypertension | ||||
| No | 459,217 | 451,223 (98.3) | 7994 (1.7) | |
| Yes | 59,972 | 56,729 (94.6) | 3243 (5.4) | 3.11 (2.98–3.23)*** |
| Antipsychotic medication | ||||
| No | 488,675 | 479,067 (98.0) | 9608 (2.0) | |
| Yes | 30,514 | 28,885 (94.7) | 1629 (5.3) | 2.72 (2.58–2.86)*** |
| Antidepressant medication | ||||
| No | 385,497 | 379,837 (98.5) | 5660 (1.5) | |
| Yes | 133,692 | 128,115 (95.8) | 5577 (4.2) | 2.84 (2.74–2.95)*** |
| Opioid medication | ||||
| No | 486,251 | 477,259 (8.2) | 8992 (1.8) | |
| Yes | 32,938 | 30,693 (93.2) | 2245 (6.8) | 3.69 (3.52–3.85)*** |
| Primary care visits | ||||
| 0 | 126,717 | 126,269 (99.6) | 448 (0.4) | |
| 1 | 90,268 | 89,491 (99.1) | 777 (0.9) | 2.43 (2.17–2.73)*** |
| 2–5 | 176,437 | 172,952 (98.0) | 3485 (2.0) | 5.59 (5.06–6.16)*** |
| 6+ | 125,767 | 119,240 (94.8) | 6527 (5.2) | 14.68 (13.34–16.15)*** |
CI, confidence interval; LUTS, lower urinary tract symptoms; PTSD, post-traumatic stress disorder; RR, risk ratio.
P <.01
P<.001.
LUTS associated ICD-9 codes: psychogenic genitourinary malfunction, unspecified (306.50), other genitourinary malfunction arising from mental factors (306.59), hypertonicity of bladder (596.51), low bladder compliance (596.52), other functional disorder of bladder (596.59),unspecified disorder of bladder (596.9), urinary obstruction, unspecified (599.60, 599.69), hypertrophy (benign) of prostate with urinary obstruction and other LUTS (600.01, 600.21, 600.91), nodular prostate with urinary obstruction (600.11), prostatitis (601.0, 601.1, 601.4, 601.8, 601.9), urinary retention (788.20), incomplete bladder emptying (788.21), urinary frequency (788.41), nocturia (788.43), urinary hesitancy (788.64), straining on urination (788.65), urinary incontinence (788.30–788.39, 788.91), splitting of urinary stream (788.61), weak urinary stream (788.62), and urinary urgency (788.63).