LUTS are very prevalent. Epidemiological studies differ in the sampling selection method, the data collecting technique, the sample size and even in the definitions adopted. In some regions studies are sometimes smaller and with important methodological limitations. This study aims to summarize the data found in the literature and identify regions of the planet with absence of robust data.

A bibliographic comprehensive revision in PubMed of all publications in English (at least the abstract) with the using mesh terms Lower Urinary Tract Symptoms and epidemiology. To ensure the quality of the bibliographic revision a specific survey was conducted for the 10 most populous countries in each continent and the studies missing added to the database. Finally, the oldest studies were added, many of them prior to the current definitions of LUTS.
This methodology was intended to include all works with scientific (due to the study design and sample size), geographical and historical relevance, and to summarize the most important works.

A total of 81 studies were selected, more than half from Europe and North America (n= 45, 56%), 33% (n=27) in Asia and Australia only 11% (n=9) from Central and South America and Africa. There’s also a 25 years difference between the first study in former and last region, and although studies numbers are stabilizing in Europe and North America, there’s a tendency to increase in the rest of the world (figure 1). When grouping the studies by decades we see that in the last decade Asia and Australia have more studies comparing with other regions. Analyzing all studies together we conclude that most of them were designed for the purpose of identifying LUTS prevalence (90.1%), 66 (81.4%) took place in a community sample but only in 59% (n=48) was the sample randomly selected. Most used face-to-face interview (n=37) followed by self-respond questionnaires (n=17).

Most studies were designed for LUTS prevalence, with sample obtained by probabilistic techniques and strong representation of the population, including whole populations analyses. There is an obvious discrepancy between the quantity and quality of existing data for Europe and North America and the rest of the world. Whereas in the Asia and Oceania there are already solid data that allow us to have a correct notion of the problem, there is still a great hole in sub-regions of South America and especially in Africa (figure 2). In developing areas, there are still major problems in studies’ design and, therefore, in the conclusions to be drawn.  The huge range of LUTS prevalence in sub-Saharan studies highlight the need for more robust works.

It is strongly accepted that LUTS are a serious health problem with a major impact on the quality of life. Acknowledging the local dimension and impact of LUTS and especially the specific characteristics of their determinants is essential to design effective medical and surgical treatment programs. It’s the authors opinion that there should be a future effort to conduct studies directly in the less studied populations, namely in sub-Saharan countries.