The psychology of LUTS: ICI-RS 2011

Introduction 
There is undoubtedly a link between lower urinary tract and psychological symptoms. The association is likely to be multifactorial, but whether psychological symptoms are causal or coincidental remains unknown. 

Methods 
This paper is a result of a think tank session conducted at the ICI-RS meeting 2011 in Bristol and a PubMed search on the subject of psychology and LUTS. 

Results 
Recent population studies have shown that LUTS are prevalent and that psychological morbidity is related to severity of LUTS. Evidence suggests that the psychological status of patients plays a significant role in their symptoms perception. Animal studies have shown the importance of programming and emotional stress on subsequent psychological problems. The link between early events in childhood and resulting LUTS in later life remains uncertain. The possibility that for some patients urinary symptoms could be part of a somatizing process requires further consideration. The possibility that patients' symptoms could be part of a somatization process needs further consideration. Neuroendocrine and neuroimaging studies suggest pathways that may link psychological and lower urinary tract functioning from early life, opening new avenues to better understand the treatment of both symptom groups. 

Conclusion 
Whilst psychological morbidity will result from any distressing chronic medical condition the possibility of causation, and or maintenance of LUTS through psychological causes requires further research. It is important to recognize that amongst our younger and older patients suffering with LUTS a significant psychological component exists. Failure to address this may lead to incomplete assessment and consequently inadequate treatment.