Sex‐Specific Digital Phenotyping of Lower Urinary Tract Symptoms: A Cross‐Sectional Study of 1586 Adults From 35 Centers in China
Abstract
ABSTRACT Background and Purpose Lower urinary tract symptoms (LUTS) represent a complex clinical syndrome with significant sexual dimorphism. Traditional “one‐size‐fits‐all” management often overlooks intra‐sex phenotypic heterogeneity. This study utilized unsupervised machine learning to identify sex‐specific digital phenotypes of LUTS within a large‐scale clinical cohort to provide a foundation for precision urological care. Materials and Methods We analyzed a multicenter database of 1586 treatment‐seeking adults (1098 females, 488 males) across 35 centers. Baseline clinical characteristics and LUTS parameters from standardized voiding diaries and validated scales were collected. K‐means clustering was performed separately by sex to identify phenotypic subtypes, with the optimal number of clusters determined by the Elbow Method and visualized via Principal Component Analysis (PCA). Results Significant sex‐specific disparities were observed: women reported a higher symptomatic burden across almost all domains but maintained better voiding satisfaction ( p < 0.001), while men exhibited poorer sleep quality ( p < 0.001). Clustering identified a consistent three‐subtype framework for both genders: Subtype 1 (Mild/Compensated): Characterized by the lowest symptom burden and highest tolerance. Subtype 2 (Storage‐Dominant with Sleep Fragmentation): Found in older populations, defined by severe nocturia, reduced bladder capacity, and profound sleep disruption. Subtype 3 (Voiding‐Dominant): Characterized by prominent dysuria and incomplete emptying. Conclusions This exploratory sex‐stratified clustering study identified symptom‐based phenotypic patterns among treatment‐seeking Chinese adults with LUTS. These findings support the potential value of a subtype‐plus‐sex framework for LUTS assessment, but prospective validation using objective functional measures and treatment outcomes is needed.
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Authors: Peixian Chen, Baojun Wang, Xiangjun Lyu, 张彩霞, Qingqing He, Qingwei Wang, Yanlan Yu, Lijuan Ren, Xiande Huang, Juan Chen, Jiao Liu, Haihong Jiang, Fei Liu, 张建军, Yuting Wu, 文伟, Juan Li, Guanghui Du, 吴小芬, Jianwei Lv, Huasheng Zhao, Xijun Weng, 孟小鑫, Qi Chen, Dongxiang Zheng, Yan Li, Li Wen, Weifang Chen, Peng Zhang, Xiao Ning, Xi Xie, Suibin Huang, Youhui Yang, Yipeng Liu, Shuxin Qu, Long Cheng, Xin Zhang, Dachuang Liu, Yi Zhang, Hao Huang, Fan Fan, Hai Huang
Institutions: Wuhan Third Hospital, Ningbo No. 2 Hospital, Zhongshan Hospital, Sun Yat-sen University, Guangdong Province Women and Children Hospital, Chinese PLA General Hospital, Second Military Medical University, Harbin Medical University, Tongji Hospital, Huazhong University of Science and Technology, Sir Run Run Shaw Hospital, First Affiliated Hospital of Xiamen University, Affiliated Hangzhou First People's Hospital, Westlake University, School of Medicine, Sun Yat-sen Memorial Hospital, Shanxi Medical University, Anhui Medical University, Second Affiliated Hospital of Anhui Medical University, Jilin University, Fourth Affiliated Hospital of Harbin Medical University, Guilin Medical University, Second Affiliated Hospital of Jilin University, First Hospital of China Medical University, Wuhan No.1 Hospital, Shanxi Provincial People’s Hospital, First Affiliated Hospital of Wenzhou Medical University, Shanghai Pudong New Area Gongli Hospital, First Hospital of Shanxi Medical University, First Affiliated Hospital of Zhengzhou University, People's Hospital of Xinjiang Uygur Autonomous Region, Lishui Central Hospital, Qilu Hospital of Shandong University, First Affiliated Hospital of Gannan Medical University, Third People's Hospital of Hefei, Shanghai First People's Hospital, Second Affiliated Hospital of Xi'an Jiaotong University, Gansu Provincial Hospital, Huizhou Central People's Hospital, Shaanxi Provincial People's Hospital, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Haikou City People's Hospital, China Rehabilitation Research Center, Second Hospital of Yichang, The Central Hospital of Shaoyang, First Affiliated Hospital of Chinese PLA General Hospital