Lower urinary tract symptoms (LUTS) are common among adults and can impair physical, psychological, and social functioning. Despite this, the biopsychosocial aspects of LUTS—especially the role of symptom awareness—remain insufficiently explored. Understanding how symptom perception affects well-being is important for improving care in primary healthcare.The primary objective was to determine whether awareness of LUTS symptoms is associated with poorer psychosocial outcomes and reduced quality of life. Additional objectives were to examine associations between LUTS type and general or social anxiety; assess whether younger adults experience greater social isolation than older adults; and evaluate whether perceived environmental support influences the subjective severity (“bothersome”) of LUTS.A cross-sectional study was conducted among 191 adults aged 18–90 years in Primorje-Gorski Kotar County, Croatia. LUTS presence and type were assessed using a validated educational screening questionnaire. Participants were categorized into three awareness groups: no LUTS, unaware LUTS, and aware LUTS. General anxiety was measured using GAD-7, social anxiety using the Liebowitz Social Anxiety Scale, and quality of life using WHOQOL-BREF. Statistical analyses included chi-square, Mann–Whitney U, Kruskal–Wallis tests, and Spearman correlations (p < 0.05).LUTS were identified in 93.7% of participants, most commonly storage symptoms. No significant associations were found between LUTS type and general or social anxiety, and social quality-of-life scores did not differ across age groups (p > 0.05). The key finding was that participants aware of having LUTS showed significantly poorer physical quality of life compared with those without LUTS and those unaware of their symptoms (p = 0.003). Perceived environmental support did not influence symptom severity.These findings suggest that symptom awareness exerts a stronger influence on patient experience than symptom type or demographic factors. Heightened bodily focus and altered perception of discomfort may contribute to reduced physical well-being, independent of anxiety or social functioning.Symptom awareness emerged as the strongest predictor of reduced physical quality of life. Integrating patient education, supportive communication, and a biopsychosocial approach into routine LUTS management may help mitigate the negative effects of symptom perception on overall well-being.