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Supplementary Material

Appendix 1 Conduct of the survey

The source of the consumer panel was Research Now Group, Inc., Plano, TX, USA. Panel research was administered by Research Now, which follows the World Association for Social, Opinion and Market Research (ESOMAR) guidelines that enshrine legal and ethical considerations of panel research, including respondent rights affecting patients/consumers who undertake market research surveys[1]. All participants sourced from customer/purchase databases, open invitations and through online partner portals of the panel owner had explicitly opted-in to receive market research survey invitations via the recruitment vendor and their fieldwork partners and received small monetary incentives to respond to surveys, in accordance with the ESOMAR market research guidelines. In addition, each interested participant was presented with full information about their rights as a market research respondent at the outset of the study.

Appendix 2Survey questionnaire: first two sections

General Demographic Questions & Screening

  1. Are you taking help of a family member/friend to complete this survey?

 Yes (1)

 No (2)

  1. What is your gender?  Male (Skip Q4) (1) Female (2)
  1. What is your age?______Years (if ≤39 years, terminate survey)
  1. (If respondent is a “Female” and answer to Q3 is <50 years ask) Are you currently pregnant?

 Yes (If “Yes” then terminate) (1)

 No (2)

  1. In the past 1 month, have you been diagnosed with a urinary tract infection or told by a physician that you have a urinary tract infection?

 Yes (If “Yes” then terminate) (1)

 No (2)

  1. What is your current marital status?

 Single (1)

 Married/living with partner (2)

 Divorced (3)

 Widow/widower (4)

 Prefer not to answer (5)

  1. What is the highest level of education you have completed?

 High school or less (1)

 Some college (2)

 College degree/college graduate (3)

 Postgraduate (4)

  1. Please specify your employment status

 Working, full-time (1)

 Working, part-time (2)

 Unemployed (3)

 Retired (4)

 Permanently disabled/cannot work due to ill health (5)

 Homemaker (6)

 Student (7)

 Other work for pay (8)

 Other (9)

Medical Comorbidity & General Health-Related Questions

  1. Do you currently suffer from diabetes?

 Yes (Go to Q9.a) (1)

 No (2)

  1. Are you currently treated for diabetes?

 Yes (1)

 No (2)

  1. Do you currently suffer from high blood pressure (hypertension)?

 Yes (Go to Q10.a) (1)

 No (2)

  1. Are you currently treated for high blood pressure?

 Yes (1)

 No (2)

  1. Do you currently suffer from heart problems (cardiac disease)?

 Yes (Go to Q11.a) (1)

 No (2)

  1. Are you currently treated for heart problems?

 Yes (1)

 No (2)

  1. Do you currently suffer from high cholesterol (hyperlipidemia)?

 Yes (Go to Q12.a) (1)

 No (2)

  1. Are you currently treated for high cholesterol?

 Yes (1)

 No (2)

  1. Do you currently suffer from any neurological disorder (e.g., multiple sclerosis, Alzheimer's disease)?

 Yes (Go to Q13.a) (1)

 No (2)

  1. Are you currently treated for this disease?

 Yes (1)

 No (2)

  1. What is your height?______feet, ______inches OR ______cm
  1. What is your current weight?______kg OR ______pounds (lb)
  1. Do you smoke?

 Yes (Go to Q16.a) (1)

 No (2)

  1. On average, how many cigarettes do you smoke in a day? ______per day
  1. Do you regularly drink alcohol?

 Yes (1)

 No (2)

Appendix 3 Scales used during the study

International Prostate Symptom Score

The International Prostate Symptom Score (IPSS) is based on answers to eight questions. Seven questions concern urinary symptoms (incomplete emptying, frequency, intermittency, urgency, weak stream, straining and nocturia) each of which is rated from 0 (no problem/no nocturia) to 5 (almost always a problem/nocturia ≥5 times) [2]. The total IPSS score is the sum of the scores from each question, with a maximum score of 35. Severity of symptoms is based on the total score: mild (score 1–7), moderate (score 8–19) and severe (score 20–35). Mild symptoms or greater reflect a score of 1–35 and moderate symptoms or greater reflect a score of 8–35. The International Scientific Committee (SCI), under the patronage of the World Health Organization (WHO) and the International Union Against Cancer (UICC), recommends the use of a single, eighth question to assess the quality of life. The patient’s feeling about spending the rest of their life with their current urinary symptoms is rated on a 7-score scale ranging from 0 (delighted) to 6 (terrible).

ICS 2002 symptoms questions

The ICS symptoms questions are divided into the three groups of symptoms identified by the ICS standardisation committee [3]: voiding, storage, and post-micturition. Questions are those used in previous similar surveys [4, 5]. There are six questions each on voiding (intermittency, weak stream, straining, splitting/spraying, hesitancy and terminal dribble) and storage symptoms (perceived daytime frequency, nocturia, urgency, urgency with fear of leaking, urgency incontinence and stress urinary incontinence) and two on post micturition symptoms. Scores for each question range from 0 (absence of symptom/urgency incontinence <1/month) to 5 (symptoms almost always present/urgency incontinence many times a day/nocturia ≥5 times). Presence of each symptom group is determined by the at least one symptom within that group being rated ≥2.

Patient Perception of Bladder Condition

The Patient Perception of Bladder Condition (PPBC) is a single-item global question that assesses the patient’s overall subjective impression of current urinary problems [6]. It is rated on a six-point scale ranging from 1 (causes no problems at all) to 6 (causes severe problems).

Supplementary Table 1 Survey sample and response rate

Email invitations, n / Responses (clicked invite link in email), n / Informed consent provided, n (%) / Completed survey
(final valid sample), n (%)
China / 399,215 / 17,233 (4.3) / 13,819 (3.5) / 4136 (1.0)
Taiwan / 51,923 / 7984 (15.4) / 5918 (11.4) / 2068 (4.0)
South Korea / 44,440 / 9585 (21.6) / 6876 (15.5) / 2080 (4.7)
Total / 495,578 / 34,802 (7.0) / 26,613 (5.4) / 8284 (1.7)

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Supplementary Table 2 PPBC and IPSS symptom severity in the overall population, and men and women

PPBC measure / IPSS score
No symptom / Mild / Moderate / Severe
Overall population, N = 8284
Does not cause me any problems at all / 1034 (94%) / 2661 (61%) / 290 (13%) / 12 (2%)
Causes me some very minor problems / 45 (4%) / 1355 (31%) / 874 (39%) / 72 (12%)
Causes me some minor problems / 11 (1%) / 302 (7%) / 680 (31%) / 153 (26%)
Causes me (some) moderate problems / 3 (0%) / 44 (1%) / 289 (13%) / 181 (30%)
Causes me severe problems / 3 (0%) / 6 (0%) / 60 (3%) / 131 (22%)
Causes me many severe problems / 0 (0%) / 4 (0%) / 28 (1%) / 47 (8%)
Causes minor problems or greater / 16 (1%) / 355 (8%) / 1058 (48%) / 511 (86%)
Causes moderate problems or greater / 6 (1%) / 53 (1%) / 378 (17%) / 358 (60%)
Causes severe problems or greater / 3 (0%) / 10 (0%) / 89 (4%) / 177 (30%)
Men, N = 4076
Does not cause me any problems at all / 480 (96%) / 1375 (66%) / 190 (16%) / 4 (1%)
Causes me some very minor problems / 13 (3%) / 592 (28%) / 457 (38%) / 44 (15%)
Causes me some minor problems / 5 (1%) / 105 (5%) / 373 (31%) / 75 (25%)
Causes me (some) moderate problems / 2 (0%) / 15 (1%) / 127 (11%) / 101 (34%)
Causes me severe problems / 1 (0%) / 3 (0%) / 30 (3%) / 52 (18%)
Causes me many severe problems / 0 (0%) / 4 (0%) / 10 (1%) / 19 (6%)
Causes minor problems or greater / 8 (2%) / 127 (6%) / 541 (46%) / 248 (84%)
Causes moderate problems or greater / 3 (1%) / 21 (1%) / 167 (14%) / 173 (59%)
Causes severe problems or greater / 1 (0%) / 7 (0%) / 40 (3%) / 71 (24%)
Women, N = 4208
Does not cause me any problems at all / 554 (93%) / 1286 (56%) / 100 (10%) / 9 (3%)
Causes me some very minor problems / 33 (5%) / 764 (34%) / 417 (40%) / 28 (9%)
Causes me some minor problems / 6 (1%) / 196 (9%) / 307 (30%) / 78 (26%)
Causes me (some) moderate problems / 1 (0%) / 29 (1%) / 162 (16%) / 79 (26%)
Causes me severe problems / 2 (0%) / 3 (0%) / 30 (3%) / 79 (26%)
Causes me many severe problems / 0 (0%) / 0 (0%) / 19 (2%) / 28 (9%)
Causes minor problems or greater / 9 (1%) / 228 (10%) / 517 (50%) / 263 (88%)
Causes moderate problems or greater / 3 (0%) / 32 (1%) / 210 (20%) / 186 (62%)
Causes severe problems or greater / 2 (0%) / 3 (0%) / 49 (5%) / 106 (35%)
IPSS international prostate symptom score,PPBC patient perception of bladder condition

Supplementary Table 3 Percentages of participants currently following LUTS treatment (overall population)

N / Prescribed medicine / Surgery / Physical therapy / Self-
treatment / Limit fluid / Limit caffeine / Limit alcohol / No drinking in night / Wearing pads / None
No LUTS / 2395 / 328
(14%) / 17
(1%) / 86
(4%) / 117
(5%) / 106
(4%) / 60
(3%) / 81
(3%) / 55
(2%) / 6
(0%) / 1832 (76%)
PM Only / 154 / 28
(18%) / 2
(2%) / 16
(10%) / 18
(12%) / 11
(7%) / 3
(2%) / 11
(7%) / 4
(3%) / 0
(0%) / 101
(66%)
Storage & PM / 234 / 56
(24%) / 4
(2%) / 23
(10%) / 41
(18%) / 64
(27%) / 20
(8%) / 20
(8%) / 31
(13%) / 14
(6%) / 93
(40%)
Storage Only / 1505 / 280
(19%) / 13
(1%) / 111
(7%) / 167
(11%) / 230 (15%) / 86
(6%) / 75
(5%) / 85
(6%) / 21
(1%) / 852
(57%)
Voiding & PM / 189 / 44
(23%) / 4
(2%) / 15
(8%) / 20
(11%) / 11
(6%) / 9
(5%) / 8
(4%) / 7
(4%) / 1
(1%) / 115
(61%)
Voiding & Storage / 831 / 226
(27%) / 19
(2%) / 147
(18%) / 185
(22%) / 196 (24%) / 87
(10%) / 92
(11%) / 81
(10%) / 26
(3%) / 290
(35%)
Voiding + Storage + PM / 1776 / 699
(39%) / 46
(3%) / 437
(25%) / 475
(27%) / 588 (33%) / 284
(16%) / 285
(16%) / 311
(17%) / 129
(7%) / 385
(22%)
Voiding Only / 371 / 66
(18%) / 4
(1%) / 17
(5%) / 35
(9%) / 22
(6%) / 9
(2%) / 16
(4%) / 13
(4%) / 0
(0%) / 249
(67%)
Overall / 7456 / 1727
(23%) / 110 (1%) / 851
(11%) / 1058 (14%) / 1227 (16%) / 557
(7%) / 588
(8%) / 587
(8%) / 197
(3%) / 3918
(53%)
LUTS lower urinary tract symptoms, PM post-micturition

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References (supplementary material)

1.World Association for Social Opinion and Market Research. ESOMAR guideline for online research. Available at: Accessed 1 February 2017.

2.Barry MJ, Fowler FJ, Jr., O'Leary MP, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148(5):154957.

3.Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):16778.

4.Sexton CC, Coyne KS, Kopp ZS, et al. The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS. BJU Int. 2009;103 (Suppl 3):12-23.

5.Coyne KS, Kvasz M, Ireland AM, Milsom I, Kopp ZS, Chapple CR. Urinary incontinence and its relationship to mental health and health-related quality of life in men and women in Sweden, the United Kingdom, and the United States. Eur Urol. 2012;61(1):88-95.

6.Coyne KS, Matza LS, Kopp Z, Abrams P. The validation of the patient perception of bladder condition (PPBC): a single-item global measure for patients with overactive bladder. Eur Urol. 2006;49(6):107986.