Background: To date, the association between obesity and lower urinary tract symptoms (LUTS) is controversial. Objective: To overcome the current inconsistent results regarding the association between obesity and LUTS and to investigate the association between obesity and LUTS using propensity score matching analysis. Setting: Bariatric center of excellence and health promotion center at university hospital. Methods: From August 2012 to December 2014, a total of 260 obese patients (77 men and 180 women) visited to our bariatric center to undergo bariatric surgery. Patients' International Prostate Symptom Score (lPSS) and overactive bladder symptom score were compared with those of 844 healthy controls who had visited our health center during the same period. To control for the effects of age, 1:1 propensity score matching was used. Results: After matching propensity score forage, 73 male patients and 176 female patients were included in our study. In men, all lPSS items except "frequency" were significantly different between obese patients and controls; median scores were higher in the obese group. In women, all IPSS items except "feeling of incomplete emptying" were significantly different between the 2 groups. Both voiding and storage subscores also had marked differences in both genders (P < .001). Total rpss, quality of life, and total overactive bladder symptom score were significantly different in both genders (P < .001). Conclusion: There were marked differences in LUTS between obese and nonobese patients, including in voiding and storage symptoms. Considering the relatively young age of both groups, this case-control study supports the hypothesis of a relationship between obesity and bladder pathophysiology. (C) 2016 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery.