J. Bosch - Academia.edu (original) (raw)

Papers by J. Bosch

Research paper thumbnail of The Association between Nocturia and Nocturnal Polyuria in Clinical and Epidemiological Studies: A Systematic Review and Meta-Analyses

The Journal of Urology, 2014

We determined the relationship between nocturia and nocturnal polyuria. The PubMed® and Embase® d... more We determined the relationship between nocturia and nocturnal polyuria. The PubMed® and Embase® databases were searched for studies written in English, German, French or Dutch with original data on adult participants in an investigation of the relationship between nocturia and nocturnal polyuria. A meta-analysis of the difference in mean nocturnal voiding frequencies between patients with and without nocturnal polyuria was conducted. Nocturnal polyuria risk was compared between participants with and without nocturia, and the resulting odds ratio was subsequently converted to relative risk with 95% CIs. From 511 references identified we selected 78 publications of 66 studies, 15 of which met the inclusion criteria for this study. Quality scores of studies were generally high for internal validity but low for external validity. In 7 studies (1,416 participants) we estimated a standardized mean difference of 0.59 (95% CI 0.29-0.89) for nocturnal voids between nocturnal polyuria and nonnocturnal polyuria cases. In 8 other studies (with 2,320 participants) we calculated a pooled OR of 4.99 (3.92-6.37) for nocturnal polyuria in individuals with nocturia. The corresponding RR, based on a nocturnal polyuria risk in the pooled population of 63.8%, was 1.41 (1.37-1.44). The association between nocturia and nocturnal polyuria is apparent and robust. However, the clinical importance of the association appears to be less obvious than previously suggested based on single studies. The observed high prevalence of nocturnal polyuria, as a result of the applied International Continence Society definition, may be responsible for this discrepancy.

Research paper thumbnail of Low predictive value of DRE and two ultrasound methods in determining changes in prostate volume

European Urology Supplements, 2003

Research paper thumbnail of Are lower urinary tract symptoms associated with cardiovascular disease in the Dutch general population? Results from the Krimpen study

World Journal of Urology, 2014

To describe the association between lower urinary tract symptoms (LUTS) and cardiovascular diseas... more To describe the association between lower urinary tract symptoms (LUTS) and cardiovascular diseases (CVD), with adjustment for age and other confounders. We were specifically interested in the possible predictive value of LUTS to the incidence of CVD in the future in the general population. We performed post hoc analyses using data from the Krimpen study, a large community-based study in the Netherlands. All men aged 50-75 years, without prostate or bladder cancer, a history of radical prostatectomy, or neurogenic bladder disease, were invited to participate for a response rate of 50 %. At baseline, 1,610 men were included. CVD status was compared to LUTS category, using logistic regression, providing odds ratios with 95 % confidence intervals (OR 95 % CI). For the longitudinal analyses in men without CVD at baseline, hazard ratios (HR) and 95 % CI were estimated using Cox proportional hazard models with the occurrence of a CVD as outcome variable. At baseline, 362 men (22 %) had a history of CVD. The ORs for CVD for men with moderate to severe LUTS were 2.04 (unadjusted, 95 % CI 1.58-2.63), 1.86 (1.43-2.41, adjusted for age), and 1.81 (1.38-2.37, adjusted for age and other confounders). Of the 1,248 CVD-free men, 58 (4.6 %) had a CVD event. HRs for moderate to severe LUTS were 0.98 (95 % CI 0.52-1.86, unadjusted) and 1.08 (0.57-2.07, adjusted for age, obesity, hypertension, and erectile dysfunction). The cross-sectional analyses revealed a clear correlation between moderate to severe LUTS and CVD. In longitudinal analyses, however, no significant association was shown.

Research paper thumbnail of High incidence of erectile and ejaculatory dysfunction and related concern in community-dwelling dutch older men

European Urology Supplements, 2003

Research paper thumbnail of Strong effects of definition and nonresponse bias on prevalence rates of clinical benign prostatic hyperplasia: the Krimpen study of male urogenital tract problems and general health status

BJU International, 2001

Objective To estimate the prevalence of benign prostatic hyperplasia (BPH) in the community, and ... more Objective To estimate the prevalence of benign prostatic hyperplasia (BPH) in the community, and study the in¯uence of BPH de®nition, age and response bias on prevalence rates. Subjects and methods A community-based longitudinal study of 3924 men aged 50±75 years was conducted in a Dutch municipality (Krimpen) near Rotterdam. Data from those responding were collected using selfadministered questionnaires, and during visits to the health centre and outpatient clinic of the urology department. The questionnaires included symptom scores on general well being (Inventory of Subjective Health, ISH) and lower urinary tract symptoms (International Prostate Symptom Score, IPSS). A short version of the questionnaire (including the IPSS and ISH) was sent to a random sample of those not responding. All subjects participating fully underwent a physical examination, uro¯owmetry, transrectal ultrasonometry of the prostate and had their prostate speci®c antigen level measured. Age-speci®c prevalence rates of BPH were estimated using different de®nitions, based on one or more of symptom severity, prostate volume and maximum¯ow rate. The in¯uence of response bias was estimated using the questionnaires. Results The response rate was 50% (full participants). Of those not responding, 55% completed a short version of the questionnaire (partial participants). Compared with full participants, partial participants had a lower IPSS and slightly lower ISH. The prevalence rates of clinical BPH in the study population was 9±20% (95% con®dence interval, 8±11% to 22±27%) depending on the de®nition used. After adjusting for nonresponse bias, the age-group speci®c prevalences for 5-year age strata were 1.1±1.8 times lower for all BPH de®nitions used. Conclusions The prevalence rates of clinical BPH depend largely on the de®nition used and increase strongly with age. The effect of age is stronger when more variables are included in the de®nition. Adjustment for response bias results in substantially lower prevalence rates.

Research paper thumbnail of 171 ESTABLISHING NORMAL REFERENCE RANGES FOR PROSTATE VOLUME CHANGE WITH AGE IN A COMMUNITY-BASED SAMPLE OF MEN AGED 50-78 YEARS

European Urology Supplements, 2007

BACKGROUND. We aim to establish the normal pattern of prostate volume change with age to provide ... more BACKGROUND. We aim to establish the normal pattern of prostate volume change with age to provide a baseline from which accelerated prostate growth might be identified in patients with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). METHODS. In a community-based study, prostate volume was determined at baseline and after 2.1 and 4.2 years in men without prostate cancer. A bivariate multilevel growth curve model was used to estimate the pattern of change of prostate volume with age. RESULTS. The average percentage increase of total prostate volume and transition zone volume per year of follow-up was 2.2% and 3.5%, respectively. The final model showed that prostate volume was related to age only. The future prostate volume of an individual can be predicted based on his age and known history of prostate volume. The model was also used to calculate time needed for the prostate volume to increase with a certain percentage, for men with different baseline prostate volume values at different ages. CONCLUSIONS. This method establishes normal prostate volume values by age using prostate volume history in men without prostate cancer. The model provides baseline data from which disease progression might be detected.

Research paper thumbnail of Loss to Follow-Up in a Longitudinal Study on Urogenital Tract Symptoms in Dutch Older Men

Urologia Internationalis, 2005

To describe loss to follow-up (LTFU) in a longitudinal community-based study on urogenital tract ... more To describe loss to follow-up (LTFU) in a longitudinal community-based study on urogenital tract dysfunction in older men. A cohort study of men recruited from a Dutch municipality was performed. A baseline study and two follow-up rounds--all with questionnaires and additional measurements--were performed with, on average, 2.1-year intervals. Baseline characteristics were compared between participants and non-participants in the first and in the second follow-up study. The response rates in the first and in the second follow-up were 78.0 and 80.0%, respectively. Various characteristics were found to be related to LTFU (i.e., more than 5% difference in response rate). Lower urinary tract symptoms were related to LTFU in the first and second follow-up. Sexual dysfunction was related to LTFU only in the second follow-up. Adjustment for confounders yielded odds ratios for the primary outcome variables (lower urinary tract symptoms, sexual dysfunction, and health status) that approximated the value of 1. LTFU according to these variables was different in men with and without other chronic illnesses. LTFU seems not to be related to the primary outcome variables in this study. Describing response patterns in longitudinal studies is important, especially in studies involving older participants, as often is the case in urological research.

Research paper thumbnail of Establishing normal reference ranges for prostate volume change with age in the population-based Krimpen-study: Prediction of future prostate volume in individual men

The Prostate, 2007

BACKGROUND. We aim to establish the normal pattern of prostate volume change with age to provide ... more BACKGROUND. We aim to establish the normal pattern of prostate volume change with age to provide a baseline from which accelerated prostate growth might be identified in patients with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). METHODS. In a community-based study, prostate volume was determined at baseline and after 2.1 and 4.2 years in men without prostate cancer. A bivariate multilevel growth curve model was used to estimate the pattern of change of prostate volume with age. RESULTS. The average percentage increase of total prostate volume and transition zone volume per year of follow-up was 2.2% and 3.5%, respectively. The final model showed that prostate volume was related to age only. The future prostate volume of an individual can be predicted based on his age and known history of prostate volume. The model was also used to calculate time needed for the prostate volume to increase with a certain percentage, for men with different baseline prostate volume values at different ages. CONCLUSIONS. This method establishes normal prostate volume values by age using prostate volume history in men without prostate cancer. The model provides baseline data from which disease progression might be detected.

Research paper thumbnail of Applicability and reproducibility of condom catheter method for measuring isovolumetric bladder pressure

Urology, 2004

De verwezenlijking van dit onderzoek en proefschri i werd mogelijk gemaakt met nanci le ondersteu... more De verwezenlijking van dit onderzoek en proefschri i werd mogelijk gemaakt met nanci le ondersteuning van De Nederlandse Niers ch ng (P85), Vereniging Trus onds Erasmus MC, S ch ng Bevordering van Volkskracht, en S ch ng Aelwijn Florisz.

Research paper thumbnail of ERECTILE DYSFUNCTION PREDICTOR FOR ACUTE MYOCARDIAL INFARCTION AND STROKE

European Urology Supplements, 2006

Research paper thumbnail of Epidemiological Aspects of Recruitment of Male Volunteers for Non-Invasive Urodynamics

Urologia Internationalis, 2006

We studied epidemiological aspects of recruitment of volunteers for a non-invasive urodynamic stu... more We studied epidemiological aspects of recruitment of volunteers for a non-invasive urodynamic study. 9,236 volunteers were invited by 20 general practitioners (GPs), using two different recruitment methods, i.e. by mail only, or during a subsequent visit to the GP's office. Factors influencing the response rates were analyzed. We also tested how much the recruited population of volunteers differed from the general population, by comparing it to another, proven representative study carried out earlier in 1,662 subjects. In the recruited population the prostate volumes were not significantly different from the proven representative study, but the symptom score was statistically significantly higher, although the difference was so small it may be called clinically irrelevant. Recruitment of volunteers in two steps, i.e. asking them first to visit the GP's office, and inviting them there to visit the outpatient clinic, rather than directly inviting them (in writing) to the clinic seemed to lead to a higher response, although this effect could not be statistically discriminated from the difference in response rates between GPs. The population recruited was not urologically different from the general population. The response depended on age, being highest around the age of 60, and increased with social economic status. It also depended on the GP who recruited the subjects, and/or on the recruitment method.

Research paper thumbnail of Establishing normal reference ranges for PSA change with age in a population-based study: The Krimpen study

The Prostate, 2006

BACKGROUND. We aim to establish the normal pattern of prostate specific antigen (PSA) change with... more BACKGROUND. We aim to establish the normal pattern of prostate specific antigen (PSA) change with age to provide a baseline from which disease progression might be identified in prostate cancer patients included in active surveillance programs. METHODS. In a community-based study, PSA values were determined at baseline and after 2.1 and 4.2 years in men without prostate cancer. A bivariate multilevel growth curve model was used to estimate the pattern of change of PSA with age. RESULTS. The final model showed that PSA was related to age only. The future PSA of an individual can be predicted based on his age and known history of PSA. The model was also used to calculate PSA doubling time for men with different PSA values at different ages. CONCLUSIONS. This method establishes normal PSA levels by age using PSA history in men without prostate cancer. The model provides baseline data from which disease progression might be detected.

Research paper thumbnail of Patient’s Quality of Life and Coping Style Influence General Practitioner’s Management in Men with Lower Urinary Tract Symptoms: The Krimpen Study

Quality of Life Research, 2006

Purpose: To identify patient characteristics associated with general practitioner's (GP) initial ... more Purpose: To identify patient characteristics associated with general practitioner's (GP) initial treatment decision in men with lower urinary tract symptoms (LUTS) and to test the hypothesis that a different coping style of patients results in different GP behaviour regarding treatment. Materials and methods: A longitudinal, population-based study with a follow-up period of 6.5 years was conducted among 1688 men aged 50-78 years old. Data were collected on quality of life, symptom severity based on the International prostate symptom score (IPSS) and coping. Information on primary care seeking and GP's initial management during 2 years of follow-up of all participants was collected from the general practitioners record. Results: Data were obtained of 68 men, without a history of LUTS, who had a first GP visit for LUTS during the study period. In 54.4% of the cases the GP prescribed medication, independent of symptom severity. In the group of men with a bad disease-specific QOL those with a high passive-reaction-pattern were treated less frequently than those with a low passive-reaction-pattern. Conclusion: Findings from this quantitative study are consistent with the hypothesis that different coping styles of patients may result in different GP behaviour regarding treatment. The use of the coping style passive-reaction-pattern has a large influence on GP's initial management in men with LUTS.

Research paper thumbnail of Erectile and ejaculatory dysfunction in a community-based sample of men 50 to 78 years old: prevalence, concern, and relation to sexual activity

Urology, 2001

To determine the prevalence rates of erectile and ejaculatory dysfunction, associated bother, and... more To determine the prevalence rates of erectile and ejaculatory dysfunction, associated bother, and their relation to sexual activity in a population-based sample of elderly men. Methods. Data were collected from 1688 men by way of self-administered questionnaires (including the International Continence Society male sex questionnaire) and measurements at a health center and urology outpatient department. Results. The prevalence of significant erectile dysfunction (ie, erections of severely reduced rigidity or no erections) increased from 3% in men 50 to 54 years old to 26% in men 70 to 78 years old. In the same age strata, the prevalence of significant ejaculatory dysfunction (ie, ejaculations with significantly reduced volume or no ejaculations) increased from 3% to 35%. Pain or discomfort during ejaculation was rare (1%) and independent of age. In general, men were more concerned about erectile dysfunction than about ejaculatory dysfunction. However, most men had no or only little concern about their dysfunction. The percentage of men who reported being sexually active declined with increasing age and was lower in men with erectile and ejaculatory dysfunction and in men without a partner. In sexually active men, 17% to 28% had no normal erections, indicating that with advancing age normal erections are not an absolute prerequisite for a sexually active life. Conclusions. Erectile and ejaculatory dysfunction are common in elderly men. The results of this study indicate that these conditions are much less of a problem for older men than previously suggested. UROLOGY 57: [763][764][765][766][767][768] 2001.

Research paper thumbnail of RISK FACTORS FOR DEVELOPING CLINICAL BENIGN PROSTATIC HYPERPLASIA: THE KRIMPEN STUDY

The Journal of Urology, 2008

Research paper thumbnail of NORMAL VOIDING PATTERNS AND DETERMINANTS OF INCREASED DIURNAL AND NOCTURNAL VOIDING FREQUENCY IN ELDERLY MEN

The Journal of Urology, 2000

Purpose: We determined the normal value of diurnal and nocturnal voiding frequency, and its deter... more Purpose: We determined the normal value of diurnal and nocturnal voiding frequency, and its determinants in a population based sample of elderly men.

Research paper thumbnail of The Natural History and Predictive Factors of Voided Volume in Older Men: The Krimpen Study

The Journal of Urology, 2011

Although functional bladder capacity, as expressed by maximum voided volume and other frequency-v... more Although functional bladder capacity, as expressed by maximum voided volume and other frequency-volume chart parameters, are important determinants of lower urinary tract symptoms, to our knowledge no population based data are available on changes in voided volume. We determined changes in and determinants of voided volume and voiding frequency with advancing age and with time, as measured by frequency-volume charts. We performed a longitudinal, population based study in 1,688 men 50 to 78 years old with followup at 2.1, 4.2 and 6.5 years. Data were obtained using frequency-volume charts for maximum, 24-hour and average voided volume, and 24-hour voiding frequency as well as physical and urological measurements, and self-administered questionnaires. We used a linear mixed effect model to determine factors predicting volume changes. Median maximum and average voided volume decreased with time from 400 to 380 and 245 to 240 ml, respectively, and were smaller in older age groups while 24-hour voided volume showed no change. The 24-hour voiding frequency increased with time and with advancing age. Maximum, 24-hour and average voided volumes were positively related to alcohol intake. Maximum and average voided volumes were negatively related to higher age at baseline and the passage of time. Hypertension, diuretics and post-void residual volume were related to higher 24-hour voided volume. In older men maximum and average voided volume show a small but statistically significant decrease with time and with advancing age while 24-hour voided volume does not. Factors predicting the change in maximum or average voided volume are alcohol intake and higher age.

Research paper thumbnail of CHANGES IN DISEASE SPECIFIC AND GENERIC QUALITY OF LIFE RELATED TO CHANGES IN LOWER URINARY TRACT SYMPTOMS: THE KRIMPEN STUDY

The Journal of Urology, 2005

Purpose: We determined if and to what extent longitudinal changes in lower urinary tract symptoms... more Purpose: We determined if and to what extent longitudinal changes in lower urinary tract symptoms are related to disease specific and generic quality of life in men.

Research paper thumbnail of Risk Factors for Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia in a Community Based Population of Healthy Aging Men: The Krimpen Study

The Journal of Urology, 2009

We explored risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperpla... more We explored risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in the open population. A longitudinal, population based study with a followup of 6.5 years was done in 1,688 men who were 50 to 78 years old. Data were collected on transrectal ultrasound of prostate volume, urinary flow rate, ultrasound estimated post-void residual urine volume, generic and disease specific quality of life, and symptom severity based on the International Prostate Symptom Score. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia were defined as an International Prostate Symptom Score of greater than 7 after a report of a score of less than 7 in the previous round. A multivariate Cox proportional hazard model was constructed to determine risk factors for clinical benign prostatic hyperplasia after correcting for patient age. Total followup was 4,353 person-years. During followup 180 events of attaining an International Prostate Symptoms Score of greater than 7 occurred. Multivariate analysis showed that functional bladder capacity, post-void residual urine volume, treatment for cardiac diseases, education level, antidepressant use, calcium antagonist use, erectile function or dysfunction, prostate specific antigen and a family history of prostate cancer were determinants with a significant HR. In addition to age, we established 9 significant determinants for lower urinary tract symptoms suggestive of benign prostatic hyperplasia. However, not all risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia are accounted for since we can conclude that 1 of 3 men without these risk factors will still be diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia between ages 50 and 80 years.

Research paper thumbnail of Erectile dysfunction prospectively associated with cardiovascular disease in the Dutch general population: results from the Krimpen Study

International Journal of Impotence Research, 2008

The possible relationship between erectile dysfunction and the later occurrence of cardiovascular... more The possible relationship between erectile dysfunction and the later occurrence of cardiovascular disease while biologically plausible has been evaluated in only a few studies. Our objective is to determine the relation between ED as defined by a single question on erectile rigidity and the later occurrence of myocardial infarction, stroke and sudden death in a population-based cohort study. In Krimpen aan den IJssel, a municipality near Rotterdam, all men aged 50-75 years, without cancer of the prostate or the bladder, without a history of radical prostectomy, neurogenic bladder disease, were invited to participate for a response rate of 50%. The answer to a single question on erectile rigidity included in the International Continence Society male sex questionnaire was used to define the severity of erectile dysfunction at baseline. Data on cardiovascular risk factors at baseline (age smoking, blood pressure, total-and high-density lipoprotein cholesterol, diabetes) were used to calculate Framingham risk scores. During an average of 6.3 years of follow-up, cardiovascular end points including acute myocardial infarction, stroke and sudden death were determined. Of the 1248 men free of CVD at baseline, 258 (22.8%) had reduced erectile rigidity and 108 (8.7%) had severely reduced erectile rigidity. In 7945 person-years of follow-up, 58 cardiovascular events occurred. In multiple variable Cox proportional hazards model adjusting for age and CVD risk score, hazard ratio was 1.6 (95% confidence interval (CI): 1.2-2.3) for reduced erectile rigidity and 2.6 (95% CI: 1.3-5.2) for severely reduced erectile rigidity. The population attributable risk fraction for reduced and severely reduced erectile rigidity was 11.7%. In this population-based study, a single question on erectile rigidity proved to be a predictor for the combined outcome of acute myocardial infarction, stroke and sudden death, independent of the risk factors used in the Framingham risk profile.

Research paper thumbnail of The Association between Nocturia and Nocturnal Polyuria in Clinical and Epidemiological Studies: A Systematic Review and Meta-Analyses

The Journal of Urology, 2014

We determined the relationship between nocturia and nocturnal polyuria. The PubMed® and Embase® d... more We determined the relationship between nocturia and nocturnal polyuria. The PubMed® and Embase® databases were searched for studies written in English, German, French or Dutch with original data on adult participants in an investigation of the relationship between nocturia and nocturnal polyuria. A meta-analysis of the difference in mean nocturnal voiding frequencies between patients with and without nocturnal polyuria was conducted. Nocturnal polyuria risk was compared between participants with and without nocturia, and the resulting odds ratio was subsequently converted to relative risk with 95% CIs. From 511 references identified we selected 78 publications of 66 studies, 15 of which met the inclusion criteria for this study. Quality scores of studies were generally high for internal validity but low for external validity. In 7 studies (1,416 participants) we estimated a standardized mean difference of 0.59 (95% CI 0.29-0.89) for nocturnal voids between nocturnal polyuria and nonnocturnal polyuria cases. In 8 other studies (with 2,320 participants) we calculated a pooled OR of 4.99 (3.92-6.37) for nocturnal polyuria in individuals with nocturia. The corresponding RR, based on a nocturnal polyuria risk in the pooled population of 63.8%, was 1.41 (1.37-1.44). The association between nocturia and nocturnal polyuria is apparent and robust. However, the clinical importance of the association appears to be less obvious than previously suggested based on single studies. The observed high prevalence of nocturnal polyuria, as a result of the applied International Continence Society definition, may be responsible for this discrepancy.

Research paper thumbnail of Low predictive value of DRE and two ultrasound methods in determining changes in prostate volume

European Urology Supplements, 2003

Research paper thumbnail of Are lower urinary tract symptoms associated with cardiovascular disease in the Dutch general population? Results from the Krimpen study

World Journal of Urology, 2014

To describe the association between lower urinary tract symptoms (LUTS) and cardiovascular diseas... more To describe the association between lower urinary tract symptoms (LUTS) and cardiovascular diseases (CVD), with adjustment for age and other confounders. We were specifically interested in the possible predictive value of LUTS to the incidence of CVD in the future in the general population. We performed post hoc analyses using data from the Krimpen study, a large community-based study in the Netherlands. All men aged 50-75 years, without prostate or bladder cancer, a history of radical prostatectomy, or neurogenic bladder disease, were invited to participate for a response rate of 50 %. At baseline, 1,610 men were included. CVD status was compared to LUTS category, using logistic regression, providing odds ratios with 95 % confidence intervals (OR 95 % CI). For the longitudinal analyses in men without CVD at baseline, hazard ratios (HR) and 95 % CI were estimated using Cox proportional hazard models with the occurrence of a CVD as outcome variable. At baseline, 362 men (22 %) had a history of CVD. The ORs for CVD for men with moderate to severe LUTS were 2.04 (unadjusted, 95 % CI 1.58-2.63), 1.86 (1.43-2.41, adjusted for age), and 1.81 (1.38-2.37, adjusted for age and other confounders). Of the 1,248 CVD-free men, 58 (4.6 %) had a CVD event. HRs for moderate to severe LUTS were 0.98 (95 % CI 0.52-1.86, unadjusted) and 1.08 (0.57-2.07, adjusted for age, obesity, hypertension, and erectile dysfunction). The cross-sectional analyses revealed a clear correlation between moderate to severe LUTS and CVD. In longitudinal analyses, however, no significant association was shown.

Research paper thumbnail of High incidence of erectile and ejaculatory dysfunction and related concern in community-dwelling dutch older men

European Urology Supplements, 2003

Research paper thumbnail of Strong effects of definition and nonresponse bias on prevalence rates of clinical benign prostatic hyperplasia: the Krimpen study of male urogenital tract problems and general health status

BJU International, 2001

Objective To estimate the prevalence of benign prostatic hyperplasia (BPH) in the community, and ... more Objective To estimate the prevalence of benign prostatic hyperplasia (BPH) in the community, and study the in¯uence of BPH de®nition, age and response bias on prevalence rates. Subjects and methods A community-based longitudinal study of 3924 men aged 50±75 years was conducted in a Dutch municipality (Krimpen) near Rotterdam. Data from those responding were collected using selfadministered questionnaires, and during visits to the health centre and outpatient clinic of the urology department. The questionnaires included symptom scores on general well being (Inventory of Subjective Health, ISH) and lower urinary tract symptoms (International Prostate Symptom Score, IPSS). A short version of the questionnaire (including the IPSS and ISH) was sent to a random sample of those not responding. All subjects participating fully underwent a physical examination, uro¯owmetry, transrectal ultrasonometry of the prostate and had their prostate speci®c antigen level measured. Age-speci®c prevalence rates of BPH were estimated using different de®nitions, based on one or more of symptom severity, prostate volume and maximum¯ow rate. The in¯uence of response bias was estimated using the questionnaires. Results The response rate was 50% (full participants). Of those not responding, 55% completed a short version of the questionnaire (partial participants). Compared with full participants, partial participants had a lower IPSS and slightly lower ISH. The prevalence rates of clinical BPH in the study population was 9±20% (95% con®dence interval, 8±11% to 22±27%) depending on the de®nition used. After adjusting for nonresponse bias, the age-group speci®c prevalences for 5-year age strata were 1.1±1.8 times lower for all BPH de®nitions used. Conclusions The prevalence rates of clinical BPH depend largely on the de®nition used and increase strongly with age. The effect of age is stronger when more variables are included in the de®nition. Adjustment for response bias results in substantially lower prevalence rates.

Research paper thumbnail of 171 ESTABLISHING NORMAL REFERENCE RANGES FOR PROSTATE VOLUME CHANGE WITH AGE IN A COMMUNITY-BASED SAMPLE OF MEN AGED 50-78 YEARS

European Urology Supplements, 2007

BACKGROUND. We aim to establish the normal pattern of prostate volume change with age to provide ... more BACKGROUND. We aim to establish the normal pattern of prostate volume change with age to provide a baseline from which accelerated prostate growth might be identified in patients with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). METHODS. In a community-based study, prostate volume was determined at baseline and after 2.1 and 4.2 years in men without prostate cancer. A bivariate multilevel growth curve model was used to estimate the pattern of change of prostate volume with age. RESULTS. The average percentage increase of total prostate volume and transition zone volume per year of follow-up was 2.2% and 3.5%, respectively. The final model showed that prostate volume was related to age only. The future prostate volume of an individual can be predicted based on his age and known history of prostate volume. The model was also used to calculate time needed for the prostate volume to increase with a certain percentage, for men with different baseline prostate volume values at different ages. CONCLUSIONS. This method establishes normal prostate volume values by age using prostate volume history in men without prostate cancer. The model provides baseline data from which disease progression might be detected.

Research paper thumbnail of Loss to Follow-Up in a Longitudinal Study on Urogenital Tract Symptoms in Dutch Older Men

Urologia Internationalis, 2005

To describe loss to follow-up (LTFU) in a longitudinal community-based study on urogenital tract ... more To describe loss to follow-up (LTFU) in a longitudinal community-based study on urogenital tract dysfunction in older men. A cohort study of men recruited from a Dutch municipality was performed. A baseline study and two follow-up rounds--all with questionnaires and additional measurements--were performed with, on average, 2.1-year intervals. Baseline characteristics were compared between participants and non-participants in the first and in the second follow-up study. The response rates in the first and in the second follow-up were 78.0 and 80.0%, respectively. Various characteristics were found to be related to LTFU (i.e., more than 5% difference in response rate). Lower urinary tract symptoms were related to LTFU in the first and second follow-up. Sexual dysfunction was related to LTFU only in the second follow-up. Adjustment for confounders yielded odds ratios for the primary outcome variables (lower urinary tract symptoms, sexual dysfunction, and health status) that approximated the value of 1. LTFU according to these variables was different in men with and without other chronic illnesses. LTFU seems not to be related to the primary outcome variables in this study. Describing response patterns in longitudinal studies is important, especially in studies involving older participants, as often is the case in urological research.

Research paper thumbnail of Establishing normal reference ranges for prostate volume change with age in the population-based Krimpen-study: Prediction of future prostate volume in individual men

The Prostate, 2007

BACKGROUND. We aim to establish the normal pattern of prostate volume change with age to provide ... more BACKGROUND. We aim to establish the normal pattern of prostate volume change with age to provide a baseline from which accelerated prostate growth might be identified in patients with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). METHODS. In a community-based study, prostate volume was determined at baseline and after 2.1 and 4.2 years in men without prostate cancer. A bivariate multilevel growth curve model was used to estimate the pattern of change of prostate volume with age. RESULTS. The average percentage increase of total prostate volume and transition zone volume per year of follow-up was 2.2% and 3.5%, respectively. The final model showed that prostate volume was related to age only. The future prostate volume of an individual can be predicted based on his age and known history of prostate volume. The model was also used to calculate time needed for the prostate volume to increase with a certain percentage, for men with different baseline prostate volume values at different ages. CONCLUSIONS. This method establishes normal prostate volume values by age using prostate volume history in men without prostate cancer. The model provides baseline data from which disease progression might be detected.

Research paper thumbnail of Applicability and reproducibility of condom catheter method for measuring isovolumetric bladder pressure

Urology, 2004

De verwezenlijking van dit onderzoek en proefschri i werd mogelijk gemaakt met nanci le ondersteu... more De verwezenlijking van dit onderzoek en proefschri i werd mogelijk gemaakt met nanci le ondersteuning van De Nederlandse Niers ch ng (P85), Vereniging Trus onds Erasmus MC, S ch ng Bevordering van Volkskracht, en S ch ng Aelwijn Florisz.

Research paper thumbnail of ERECTILE DYSFUNCTION PREDICTOR FOR ACUTE MYOCARDIAL INFARCTION AND STROKE

European Urology Supplements, 2006

Research paper thumbnail of Epidemiological Aspects of Recruitment of Male Volunteers for Non-Invasive Urodynamics

Urologia Internationalis, 2006

We studied epidemiological aspects of recruitment of volunteers for a non-invasive urodynamic stu... more We studied epidemiological aspects of recruitment of volunteers for a non-invasive urodynamic study. 9,236 volunteers were invited by 20 general practitioners (GPs), using two different recruitment methods, i.e. by mail only, or during a subsequent visit to the GP's office. Factors influencing the response rates were analyzed. We also tested how much the recruited population of volunteers differed from the general population, by comparing it to another, proven representative study carried out earlier in 1,662 subjects. In the recruited population the prostate volumes were not significantly different from the proven representative study, but the symptom score was statistically significantly higher, although the difference was so small it may be called clinically irrelevant. Recruitment of volunteers in two steps, i.e. asking them first to visit the GP's office, and inviting them there to visit the outpatient clinic, rather than directly inviting them (in writing) to the clinic seemed to lead to a higher response, although this effect could not be statistically discriminated from the difference in response rates between GPs. The population recruited was not urologically different from the general population. The response depended on age, being highest around the age of 60, and increased with social economic status. It also depended on the GP who recruited the subjects, and/or on the recruitment method.

Research paper thumbnail of Establishing normal reference ranges for PSA change with age in a population-based study: The Krimpen study

The Prostate, 2006

BACKGROUND. We aim to establish the normal pattern of prostate specific antigen (PSA) change with... more BACKGROUND. We aim to establish the normal pattern of prostate specific antigen (PSA) change with age to provide a baseline from which disease progression might be identified in prostate cancer patients included in active surveillance programs. METHODS. In a community-based study, PSA values were determined at baseline and after 2.1 and 4.2 years in men without prostate cancer. A bivariate multilevel growth curve model was used to estimate the pattern of change of PSA with age. RESULTS. The final model showed that PSA was related to age only. The future PSA of an individual can be predicted based on his age and known history of PSA. The model was also used to calculate PSA doubling time for men with different PSA values at different ages. CONCLUSIONS. This method establishes normal PSA levels by age using PSA history in men without prostate cancer. The model provides baseline data from which disease progression might be detected.

Research paper thumbnail of Patient’s Quality of Life and Coping Style Influence General Practitioner’s Management in Men with Lower Urinary Tract Symptoms: The Krimpen Study

Quality of Life Research, 2006

Purpose: To identify patient characteristics associated with general practitioner's (GP) initial ... more Purpose: To identify patient characteristics associated with general practitioner's (GP) initial treatment decision in men with lower urinary tract symptoms (LUTS) and to test the hypothesis that a different coping style of patients results in different GP behaviour regarding treatment. Materials and methods: A longitudinal, population-based study with a follow-up period of 6.5 years was conducted among 1688 men aged 50-78 years old. Data were collected on quality of life, symptom severity based on the International prostate symptom score (IPSS) and coping. Information on primary care seeking and GP's initial management during 2 years of follow-up of all participants was collected from the general practitioners record. Results: Data were obtained of 68 men, without a history of LUTS, who had a first GP visit for LUTS during the study period. In 54.4% of the cases the GP prescribed medication, independent of symptom severity. In the group of men with a bad disease-specific QOL those with a high passive-reaction-pattern were treated less frequently than those with a low passive-reaction-pattern. Conclusion: Findings from this quantitative study are consistent with the hypothesis that different coping styles of patients may result in different GP behaviour regarding treatment. The use of the coping style passive-reaction-pattern has a large influence on GP's initial management in men with LUTS.

Research paper thumbnail of Erectile and ejaculatory dysfunction in a community-based sample of men 50 to 78 years old: prevalence, concern, and relation to sexual activity

Urology, 2001

To determine the prevalence rates of erectile and ejaculatory dysfunction, associated bother, and... more To determine the prevalence rates of erectile and ejaculatory dysfunction, associated bother, and their relation to sexual activity in a population-based sample of elderly men. Methods. Data were collected from 1688 men by way of self-administered questionnaires (including the International Continence Society male sex questionnaire) and measurements at a health center and urology outpatient department. Results. The prevalence of significant erectile dysfunction (ie, erections of severely reduced rigidity or no erections) increased from 3% in men 50 to 54 years old to 26% in men 70 to 78 years old. In the same age strata, the prevalence of significant ejaculatory dysfunction (ie, ejaculations with significantly reduced volume or no ejaculations) increased from 3% to 35%. Pain or discomfort during ejaculation was rare (1%) and independent of age. In general, men were more concerned about erectile dysfunction than about ejaculatory dysfunction. However, most men had no or only little concern about their dysfunction. The percentage of men who reported being sexually active declined with increasing age and was lower in men with erectile and ejaculatory dysfunction and in men without a partner. In sexually active men, 17% to 28% had no normal erections, indicating that with advancing age normal erections are not an absolute prerequisite for a sexually active life. Conclusions. Erectile and ejaculatory dysfunction are common in elderly men. The results of this study indicate that these conditions are much less of a problem for older men than previously suggested. UROLOGY 57: [763][764][765][766][767][768] 2001.

Research paper thumbnail of RISK FACTORS FOR DEVELOPING CLINICAL BENIGN PROSTATIC HYPERPLASIA: THE KRIMPEN STUDY

The Journal of Urology, 2008

Research paper thumbnail of NORMAL VOIDING PATTERNS AND DETERMINANTS OF INCREASED DIURNAL AND NOCTURNAL VOIDING FREQUENCY IN ELDERLY MEN

The Journal of Urology, 2000

Purpose: We determined the normal value of diurnal and nocturnal voiding frequency, and its deter... more Purpose: We determined the normal value of diurnal and nocturnal voiding frequency, and its determinants in a population based sample of elderly men.

Research paper thumbnail of The Natural History and Predictive Factors of Voided Volume in Older Men: The Krimpen Study

The Journal of Urology, 2011

Although functional bladder capacity, as expressed by maximum voided volume and other frequency-v... more Although functional bladder capacity, as expressed by maximum voided volume and other frequency-volume chart parameters, are important determinants of lower urinary tract symptoms, to our knowledge no population based data are available on changes in voided volume. We determined changes in and determinants of voided volume and voiding frequency with advancing age and with time, as measured by frequency-volume charts. We performed a longitudinal, population based study in 1,688 men 50 to 78 years old with followup at 2.1, 4.2 and 6.5 years. Data were obtained using frequency-volume charts for maximum, 24-hour and average voided volume, and 24-hour voiding frequency as well as physical and urological measurements, and self-administered questionnaires. We used a linear mixed effect model to determine factors predicting volume changes. Median maximum and average voided volume decreased with time from 400 to 380 and 245 to 240 ml, respectively, and were smaller in older age groups while 24-hour voided volume showed no change. The 24-hour voiding frequency increased with time and with advancing age. Maximum, 24-hour and average voided volumes were positively related to alcohol intake. Maximum and average voided volumes were negatively related to higher age at baseline and the passage of time. Hypertension, diuretics and post-void residual volume were related to higher 24-hour voided volume. In older men maximum and average voided volume show a small but statistically significant decrease with time and with advancing age while 24-hour voided volume does not. Factors predicting the change in maximum or average voided volume are alcohol intake and higher age.

Research paper thumbnail of CHANGES IN DISEASE SPECIFIC AND GENERIC QUALITY OF LIFE RELATED TO CHANGES IN LOWER URINARY TRACT SYMPTOMS: THE KRIMPEN STUDY

The Journal of Urology, 2005

Purpose: We determined if and to what extent longitudinal changes in lower urinary tract symptoms... more Purpose: We determined if and to what extent longitudinal changes in lower urinary tract symptoms are related to disease specific and generic quality of life in men.

Research paper thumbnail of Risk Factors for Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia in a Community Based Population of Healthy Aging Men: The Krimpen Study

The Journal of Urology, 2009

We explored risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperpla... more We explored risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in the open population. A longitudinal, population based study with a followup of 6.5 years was done in 1,688 men who were 50 to 78 years old. Data were collected on transrectal ultrasound of prostate volume, urinary flow rate, ultrasound estimated post-void residual urine volume, generic and disease specific quality of life, and symptom severity based on the International Prostate Symptom Score. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia were defined as an International Prostate Symptom Score of greater than 7 after a report of a score of less than 7 in the previous round. A multivariate Cox proportional hazard model was constructed to determine risk factors for clinical benign prostatic hyperplasia after correcting for patient age. Total followup was 4,353 person-years. During followup 180 events of attaining an International Prostate Symptoms Score of greater than 7 occurred. Multivariate analysis showed that functional bladder capacity, post-void residual urine volume, treatment for cardiac diseases, education level, antidepressant use, calcium antagonist use, erectile function or dysfunction, prostate specific antigen and a family history of prostate cancer were determinants with a significant HR. In addition to age, we established 9 significant determinants for lower urinary tract symptoms suggestive of benign prostatic hyperplasia. However, not all risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia are accounted for since we can conclude that 1 of 3 men without these risk factors will still be diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia between ages 50 and 80 years.

Research paper thumbnail of Erectile dysfunction prospectively associated with cardiovascular disease in the Dutch general population: results from the Krimpen Study

International Journal of Impotence Research, 2008

The possible relationship between erectile dysfunction and the later occurrence of cardiovascular... more The possible relationship between erectile dysfunction and the later occurrence of cardiovascular disease while biologically plausible has been evaluated in only a few studies. Our objective is to determine the relation between ED as defined by a single question on erectile rigidity and the later occurrence of myocardial infarction, stroke and sudden death in a population-based cohort study. In Krimpen aan den IJssel, a municipality near Rotterdam, all men aged 50-75 years, without cancer of the prostate or the bladder, without a history of radical prostectomy, neurogenic bladder disease, were invited to participate for a response rate of 50%. The answer to a single question on erectile rigidity included in the International Continence Society male sex questionnaire was used to define the severity of erectile dysfunction at baseline. Data on cardiovascular risk factors at baseline (age smoking, blood pressure, total-and high-density lipoprotein cholesterol, diabetes) were used to calculate Framingham risk scores. During an average of 6.3 years of follow-up, cardiovascular end points including acute myocardial infarction, stroke and sudden death were determined. Of the 1248 men free of CVD at baseline, 258 (22.8%) had reduced erectile rigidity and 108 (8.7%) had severely reduced erectile rigidity. In 7945 person-years of follow-up, 58 cardiovascular events occurred. In multiple variable Cox proportional hazards model adjusting for age and CVD risk score, hazard ratio was 1.6 (95% confidence interval (CI): 1.2-2.3) for reduced erectile rigidity and 2.6 (95% CI: 1.3-5.2) for severely reduced erectile rigidity. The population attributable risk fraction for reduced and severely reduced erectile rigidity was 11.7%. In this population-based study, a single question on erectile rigidity proved to be a predictor for the combined outcome of acute myocardial infarction, stroke and sudden death, independent of the risk factors used in the Framingham risk profile.