The International Continence Society “Benign Prostatic Hyperplasia” Study: The Bothersomeness of Urinary Symptoms (original) (raw)
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The Journal of Urology, 1997
Purpose: We investigated the international differences in the reporting of lower urinary tract symptoms and related bother in patients with symptoms suggestive of bladder outlet obstruction. Materials and Methods: Multiple logistic regression analysis was used to evaluate interna tional differences in the reporting of lower urinary tract symptoms and related bother in 1,271 patients from 12 countries who participated in the International Continence Society "benign prostatic hyperplasia" study. Results: Country of origin was significantly associated with the prevalence of a large number of lower urinary tract symptoms (10 of 20), even after adjusting for potentially confounding variables, including physical and socio-demographic factors. Country of origin was also signifi cantly associated with the reporting of bother but for a much smaller number of symptoms (2). Conclusions: In different countries lower urinary tract symptoms may be reported to different extents. Therefore, the results of studies in particular countries may not be generally applicable to other countries. It is likely that symptom scores will conceal this variation, necessitating consid eration of individual symptoms (as in the International Continence Society "benign prostatic hyper plasia" study) or the development of country specific scoring systems. An alternative would be to focus on bother, which appeared to be much less sensitive to international differences.
2011
Given the ageing of western populations, the cost burden associated with the treatment of LUTS suggestive of BPO will increase substantially over the next few decades. Therefore, from the economic perspective, the primary objective of the Triumph project is the assessment of the cost-effectiveness of treatment options for lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO), formerly referred to as symptomtic benign prostatic hyperplasia (BPH), in medical practice in initially six European countries. All modalities of LUTS treatment used in these countries will be considered. The effectiveness and costs associated with these treatments will be assessed in each country. Data will be gathered from observed medical practice rather than in the setting of a trial. Country-specific aspects will be studied and the outcome of country-specific policies can be predicted. Patient quality of life will also be measured using the I-PSS score as a basis. A number of treatment scenarios will be assessed in terms of both their costs and long-term effects, using a computer simula-tion. These economic analyses will provide greatly improved insight into the most cost-effective treatments for LUTS suggestive of BPO.
New Concepts in Epidemiology of Lower Urinary Tract Symptoms in Men
European Urology Supplements, 2010
Context: Recent insights into the pathophysiology of lower urinary tract symptoms (LUTS) have led to the introduction of new concepts, such as postmicturition LUTS as a third category alongside voiding and storage LUTS; the consideration of the lower urinary tract as a functional unit, in view of the importance of the role of the bladder in LUTS; and the realization that the prevalence of LUTS is similar in the two genders. Objective: Verify whether epidemiologic information supports these concepts. Evidence acquisition: Four important epidemiologic studies-the International Continence Society ''Benign Prostatic Hyperplasia'' (ICS-BPH) study, the EPIC survey, the Boston Area Community Health (BACH) survey, and the Epidemiology of LUTS (EpiLUTS) survey-were identified and reviewed. Evidence synthesis: The epidemiologic findings not only support these concepts but also have provided additional information that should be borne in mind for the management of LUTS. Findings include the facts that voiding symptoms are more common in men and storage symptoms are more common in women, that the prevalence of LUTS does not differ by race, and that treatment seeking by patients with LUTS is very low. In addition, LUTS have been found to be associated with chronic diseases. This observation may lead to insights into the pathophysiology of LUTS. Conclusion: Epidemiologic studies support the new concepts.
INTRODUCTION Lower urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH) are common clinical presentation in elderly men. It affects 15-60% of patients greater than 40 years which poses public health burden. 1,2 LUTS are used to define the complex of those symptoms which includes bladder storage, sensation or voiding symptoms. These symptoms are often associated with prostate enlargement which is a common aetiology of ABSTRACT Background: Lower urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH) are common in the elderly. This study sought to determine the prevalence of LUTS among patients visiting the urology clinic at Komfo Anokye Teaching Hospital, Kumasi, Ghana and to explore its presentation patterns. Methods: Simple randomized sampling technique was used to recruit 225 subjects with a mean age of 67.96±14.57 (range=40-100years) in a prospective cross-sectional study. LUTS related characteristics and international prostate symptom score (IPSS) questionnaire were employed to obtain relevant data. Results: The average IPSS of the studied participants was 17.52±7.83. Based on the IPSS, the prevalence of LUTS suggestive of BPH was 88.89%. Bladder storage symptoms were also recorded at 88.59% whilst prostate enlargement based on digital rectal examination (DRE) was 60.4% among the studied subjects. PSA levels ≥4.0ng/ml gave a prevalence of 81.5%. The prevalence of prostate enlargement defined as PSA ≥1.5ng/ml was 85.23% among the studied subjects whilst 63.11% of the subjects examined had troublesome LUTS. Urgency was the most predominantly reported LUTS (93.3%) among the subjects studied. Conclusions: This study has clearly shown that, the most prevalent urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia were bladder storage symptoms and urgency. These symptoms when present clinically therefore, suggest benign prostatic hyperplasia and that the prevalence estimates of LUTS in older men are relatively higher at diagnosis.
Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors
Current Bladder Dysfunction Reports, 2010
The epidemiology of benign prostatic hyperplasia (BPH) and male lower urinary tract symptoms (LUTS) has evolved considerably during the past several years. The term LUTS describes a distinct phenotype and allows for a broad epidemiologic description of urinary symptoms at a population level. Although it is becoming the preferred term for studying urinary symptoms in populations, LUTS remains interconnected with
Urology, 2011
After screening men aged 40 years or older for lower urinary tract symptoms (LUTS) indicative of benign prostatic hyperplasia over the years 1999 to 2000, non-treated men with an initial International Prostate Symptoms Score (I-PSS) equal to or lower than 2 were assessed 2 years later for symptom progression. METHODS A cross-sectional study was conducted in 1999 on 1804 men aged 40 years or older who were living in Madrid. In a telephone interview sociodemographic information was requested and LUTS assessed using the I-PSS. Of 975 men with no LUTS or lower than 2 in this baseline survey, 463 were re-interviewed in 2001. The dependent variable was the change from null/mild to moderate/severe LUTS produced over 2 years. RESULTS Over the 2-year period, the mean increase in I-PSS score was 2.20 (95% CI, 1.89-2.51). The cumulative incidence of progression from asymptomatic/mild to moderate/severe disease was 9.94% (95% CI, 7.53-13.00). In the multivariate logistic regression model men who lived in a rural setting (OR, 2.70; P ϭ .01) and armed forces, qualified agriculture and fishing workers (OR, 4.11; P ϭ .05) were independently associated with progression. Age and alcohol intake were also found to interact; intake of 0.01-25.99 g/day in men older than 50 years (OR, 0.28; P ϭ .008) was related to a lower frequency of progression than the same alcohol intake in men younger than 50 years (OR, 2.03; P ϭ .380). CONCLUSIONS After the 2-year period, the incidence of symptom progression was 10% in men aged 40 years or older with an initial I-PSS equal to or lower than 2. UROLOGY 77: 693-698, 2011.