{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:51:36Z","timestamp":1791373896920,"version":"4.3.1"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Lower urinary tract symptoms (LUTS) represent a complex clinical syndrome with significant sexual dimorphism. Traditional \u201cone\u2010size\u2010fits\u2010all\u201d management often overlooks intra\u2010sex phenotypic heterogeneity. This study utilized unsupervised machine learning to identify sex\u2010specific digital phenotypes of LUTS within a large\u2010scale clinical cohort to provide a foundation for precision urological care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We analyzed a multicenter database of 1586 treatment\u2010seeking adults (1098 females, 488 males) across 35 centers. Baseline clinical characteristics and LUTS parameters from standardized voiding diaries and validated scales were collected. K\u2010means 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant sex\u2010specific disparities were observed: women reported a higher symptomatic burden across almost all domains but maintained better voiding satisfaction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while men exhibited poorer sleep quality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Clustering identified a consistent three\u2010subtype framework for both genders: Subtype 1 (Mild\/Compensated): Characterized by the lowest symptom burden and highest tolerance. Subtype 2 (Storage\u2010Dominant with Sleep Fragmentation): Found in older populations, defined by severe nocturia, reduced bladder capacity, and profound sleep disruption. Subtype 3 (Voiding\u2010Dominant): Characterized by prominent dysuria and incomplete emptying.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This exploratory sex\u2010stratified clustering study identified symptom\u2010based phenotypic patterns among treatment\u2010seeking Chinese adults with LUTS. These findings support the potential value of a subtype\u2010plus\u2010sex framework for LUTS assessment, but prospective validation using objective functional measures and treatment outcomes is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70466","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:08:01Z","timestamp":1791371281000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex\u2010Specific Digital Phenotyping of Lower Urinary Tract Symptoms: A Cross\u2010Sectional Study of 1586 Adults From 35 Centers in China"],"prefix":"10.1002","author":[{"given":"Peixian","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4036-9470","authenticated-orcid":false,"given":"Baojun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Medical Center of PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangjun","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Urology The Third Medical Center of PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caixia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"He","sequence":"additional","affiliation":[{"name":"Department of Urology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Zhengzhou University Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanlan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Urology, Sir Run Run Shaw Hospital Zhejiang University School of Medicine Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijuan","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Urology The First Hospital of Shanxi Medical University Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiande","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Urology Gansu Provincial Hospital Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology Shaanxi Provincial People's Hospital Xi'an 710068 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of China Medical University Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8365-3438","authenticated-orcid":false,"given":"Haihong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Wenzhou Medical University Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Xiamen University Xiamen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology Xinjiang Uygur Autonomous Region People's Hospital Urumqi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuting","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Gannan Medical University Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Urology Shanghai First People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology The Third Medical Center of PLA General Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanghui","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Urology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology Lishui Central Hospital Lishui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwei","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Urology Shanghai Pudong New Area Gongli Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huasheng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Urology Shaoyang Central Hospital Shaoyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xijun","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Urology Ningbo Yinzhou No.2 Hospital (Ningbo Urological and Nephrological Hospital) Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxin","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Urology Jiangsu Provincial People's Hospital Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology The Second Affiliated Hospital of Xi'an Jiaotong University Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxiang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Urology Zhongshan Hospital of Traditional Chinese Medicine Zhongshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4847-3037","authenticated-orcid":false,"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology Qilu Hospital of Shandong University Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Urology Haikou People's Hospital Haikou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Guangdong Provincial Maternity and Child Health Care Hospital Guangzhou 510010 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology China Rehabilitation Research Center Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4842-0456","authenticated-orcid":false,"given":"Ning","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Urology Guilin Second People's Hospital Guilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Urology Hangzhou First People's Hospital Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suibin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Urology Wuhan First Hospital Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4670-1628","authenticated-orcid":false,"given":"Youhui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology Yichang Second People's Hospital Yichang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yipeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology Wuhan First Hospital Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuxin","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Urology The Fourth Hospital of Harbin Medical University Harbin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4432-5264","authenticated-orcid":false,"given":"Long","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Urology Huizhou Third People's Hospital Huizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology Jiangsu Provincial Hospital of Traditional Chinese Medicine Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dachuang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology Anhui Second People's Hospital Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology The Second Hospital of Jilin University Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Urology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Urology, Sun Yat\u2010sen Memorial Hospital Sun Yat\u2010sen University Guangzhou 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C.","year":"2018","journal-title":"Neurourology and Urodynamics"},{"issue":"12","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1111\/ijcp.12727","article-title":"Nocturia: Risk Factors and Associated Comorbidities; Findings From the EpiLUTS Study","volume":"69","author":"Madhu C.","year":"2015","journal-title":"International Journal of Clinical Practice"},{"issue":"9","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1001\/jama.2025.7045","article-title":"Lower Urinary Tract Symptoms in Men: A Review","volume":"334","author":"Wei J. T.","year":"2025","journal-title":"Journal of the American Medical Association"},{"issue":"6","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"2286","DOI":"10.1016\/j.juro.2008.01.098","article-title":"Stress Urinary Incontinence: Relative Importance of Urethral Support and Urethral Closure Pressure","volume":"179","author":"Delancey J. O. L.","year":"2008","journal-title":"Journal of Urology"},{"issue":"6","key":"e_1_2_11_8_1","first-page":"581","article-title":"Differences in Continence System Between Community\u2010Dwelling Black and White Women With and Without Urinary Incontinence in the EPI Study","volume":"202","author":"Delancey J. O. L.","year":"2010","journal-title":"American Journal of Obstetrics and Gynecology"},{"issue":"4","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/j.juro.2017.10.035","article-title":"Baseline Lower Urinary Tract Symptoms in Patients Enrolled in LURN: A Prospective, Observational Cohort Study","volume":"199","author":"Cameron A. P.","year":"2018","journal-title":"Journal of Urology"},{"issue":"8","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1002\/nau.25566","article-title":"Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN): An Introduction to the Urinary Urgency Phenotyping Protocol LURN II","volume":"43","author":"Cameron A. P.","year":"2024","journal-title":"Neurourology and Urodynamics"},{"issue":"1","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1002\/nau.24219","article-title":"Longitudinal Changes in Symptom\u2010Based Female and Male LUTS Clusters","volume":"39","author":"Amundsen C. L.","year":"2020","journal-title":"Neurourology and Urodynamics"},{"issue":"1","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.juro.2016.01.007","article-title":"Symptoms of Lower Urinary Tract Dysfunction Research Network","volume":"196","author":"Yang C. C.","year":"2016","journal-title":"Journal of Urology"},{"issue":"9","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1111\/j.1742-1241.2010.02450.x","article-title":"Assessing Patients' Descriptions of Lower Urinary Tract Symptoms (LUTS) and Perspectives on Treatment Outcomes: Results of Qualitative Research: Patients\u2019 Descriptions of LUTS and Treatment Outcomes","volume":"64","author":"Coyne K. 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P.","year":"2018","journal-title":"Journal of Urology"},{"issue":"1","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1002\/nau.25067","article-title":"Treatment Patterns in Women With Urinary Urgency And\/Or Urgency Urinary Incontinence in the Symptoms of Lower Urinary Tract Dysfunction Research Network Observational Cohort Study","volume":"42","author":"Bretschneider C. E.","year":"2023","journal-title":"Neurourology and Urodynamics"},{"issue":"1","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/JU.0000000000002493","article-title":"Impact of Sleep Disturbance, Physical Function, Depression and Anxiety on Male Lower Urinary Tract Symptoms: Results From the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)","volume":"208","author":"Glaser A. P.","year":"2022","journal-title":"Journal of Urology"},{"issue":"10","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1111\/j.1464-410X.2008.07598.x","article-title":"Examining Lower Urinary Tract Symptom Constellations Using Cluster Analysis","volume":"101","author":"Coyne K. S.","year":"2008","journal-title":"BJU International"},{"issue":"10","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1111\/j.1464-410X.2008.07653.x","article-title":"Beyond the Cluster: Methodological and Clinical Implications in the Boston Area Community Health Survey and EPIC Studies","volume":"101","author":"Rosen R. C.","year":"2008","journal-title":"BJU International"},{"issue":"10","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1111\/j.1464-410X.2008.07557.x","article-title":"Do Urological Symptoms Cluster Among Women? Results From the Boston Area Community Health Survey","volume":"101","author":"Hall S. A.","year":"2008","journal-title":"BJU International"},{"issue":"6","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0268547","article-title":"Subtyping of Common Complex Diseases and Disorders by Integrating Heterogeneous Data. Identifying Clusters Among Women With Lower Urinary Tract Symptoms in the LURN Study","volume":"17","author":"Andreev V. P.","year":"2022","journal-title":"PLoS One"},{"issue":"4","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"3175","DOI":"10.1109\/TPAMI.2024.3521022","article-title":"Manifold Based Multi\u2010View k\u2010Means","volume":"47","author":"Gao Q.","year":"2025","journal-title":"IEEE Transactions on Pattern Analysis and Machine Intelligence"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70466","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.70466","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70466","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:08:05Z","timestamp":1791371285000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.70466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":25,"alternative-id":["10.1002\/nau.70466"],"URL":"https:\/\/doi.org\/10.1002\/nau.70466","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"assertion":[{"value":"2026-06-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"nau.70466"}}