Lower urinary tract symptoms; an undetected cause for morbidity in adults.

INTRODUCTION: Lower urinary tract symptoms (LUTS) have been recognised as a cause of distress among adult men and women. In view of the increasing elderly population in Sri Lanka, the number of individuals with LUTS is likely to increase. OBJECTIVES: To determine the prevalence and severity of LUTS in a community sample of older men and women residing in an urban area. DESIGN: Cross-sectional descriptive study. SETTING: Field practice area of National Institute of Health Sciences, Kalutara. METHODS: Households were selected using probability proportionate to the size (PPS) method. 985 adult men and women (above 40 years of age) were interviewed by Public Health Midwives regarding LUTS using an interviewer-administered questionnaire. The questions were adapted from ICSmale questionnaire and the Bristol Female Lower Urinary Tract questionnaire. RESULTS: 209 (47%) men and 338 (62.6%) women reported at least one urinary symptom. In men, urgency, nocturia, dysuria and frequency were the most prevalent symptoms with stress incontinence being the least prevalent. Majority of the symptoms showed an increase in prevalence with age. In women, dysuria, stress incontinence, urgency and frequency were the most prevalent symptoms. Hesitancy, intermittency, and stress and urge incontinence were the most bothersome symptoms among men, and urge and stress incontinence among women. CONCLUSIONS: Prevalence of LUTS was high in our study population.

Breast examination of older women in a teaching hospital.

INTRODUCTION: Breast examination during routine physical examination may help detect breast cancer and effect early treatment. OBJECTIVE: To determine whether doctors routinely perform breast examination in older women, and to assess attitudes of patients and doctors to this examination. METHODS: A questionnaire based survey of 150 women over 65 years attending a teaching hospital, and 51 doctors working in this hospital. RESULTS: Very few women had a breast examination performed by a doctor. All thought breast examination was important, and would give consent for this examination. Although the great majority of doctors thought breast examination should be done routinely only very few do so. CONCLUSION: Older women have a positive attitude towards breast examination, but this is not reflected by the practice of doctors. There is a need for change in attitudes and training among doctors so that breast examination would be performed routinely.