PROJECT SUMMARY/ABSTRACT Lower urinary tract symptoms (LUTS) are common and have a significant negative impact on the lives of adult men and women. The Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) was formed in 2012 to address research gaps related to the care of patients with LUTS. The long-term goals of the University of Iowa LURN Research Site are to better treat and prevent lower urinary tract dysfunction in men and women. Toward this goal, additional research is required to better characterize and understand clinically-useful LUTS patient subtypes and to better measure the full patient experience related to the broad range of LUTS. The Iowa Research Site thus proposes to perform multicenter and multidisciplinary research with other LURN sites to 1) Test and refine LURN symptom-based clusters including a wider range of symptom severity and a wider range of physiological measures than performed in prior studies, 2) Assess the relationship between physical activity and sleep (important non-urologic factors related to LUTS) and LUTS and LUTS treatment response, 3) Determine phenotypic characteristics of women with LUTS by measuring the functional components via urodynamic testing, 4) Identify protein biomarker signatures contained within plasma of specific subgroups of men and women with LUTS, and 5) Validate a comprehensive outcome tool for men and women with LUTS. To address these aims, several distinct but complementary studies are proposed. LURN will perform a 3-year cohort study of men and women with a diverse spectrum of LUTS severity and characterize them with standardized clinical evaluations, self-reported symptoms and associated conditions, quality of life, voiding diaries and detailed information on treatments and treatment response over time. Wearable health tracking devices and smartphone text messaging technologies will be utilized to collect objective physical activity and sleep quality data from cohort study participants. Additionally, participants will complete the LURN Comprehensive Assessment of Self-Reported Urinary Symptoms ? Outcome Measure (CASUS-OM) to test its internal consistency, validity and responsiveness to change after LUTS treatments. In another study, women with urgency and urgency urinary incontinence will undergo a battery of standardized urodynamic tests focused on sensory and motor functions of the urethra and bladder. Lastly, analysis of protein biomarker signatures will be performed, using plasma samples previously collected from men and women with LUTS. Important findings from these significant LURN research efforts will help improve the clinical care of LUTS patients and will inform the development of future LUTS clinical studies.