The International Continence Society “Benign Prostatic Hyperplasia” Study: The Bothersomeness of Urinary Symptoms (original) (raw)
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.
Federal Practitioner, 2021
• FEDERAL PRACTITIONER • 573 mdedge.com/fedprac Background: Benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) are common clinical encounters for most primary care practitioners (PCPs). More than 50% of men aged > 50 years will develop significant lower urinary tract symptoms. Managing these symptoms can be complicated and requires an informed discussion between the PCP and the patient. This article provides a comprehensive review for PCPs regarding the evaluation and management of LUTS in men and when to consider a urology referral. Observations: Over the past 3 decades, medications have become the most common BPH and LUTS therapy, but recently, newer minimally invasive surgeries have challenged this paradigm. PCPs are in a unique position to help many patients who present with early stage LUTS. Conclusions: A clear understanding of the available treatment options will help PCPs counsel patients appropriately about lifestyle modification, medications, and surgical treatment options for their symptoms.
The Canadian journal of urology, 2011
Significant lower urinary tract symptoms (LUTS) are very common in men over age 50. It is appropriate for the primary care physician to perform the work up to confirm that benign prostatic hyperplasia (BPH) is causing the LUTS. If the physician determines that the patient has moderate symptoms (an International Prostate Symptom Score [IPSS] ≥ 8), moderate 'bother' (≥ 3 on the IPSS "bothersome index" question), and an enlarged (> 30 cc) prostate, then the most effective treatment is combination therapy with an alpha blocker and 5-alpha reductase inhibitor (5-ARI) at the time of confirmed BPH diagnosis. This combination will provide the most dramatic, early symptom response, the most sustained symptom response, and the most durable, reliable prevention of long term sequelae (acute urinary retention or the need for surgery), if the patient is compliant with taking the combination therapy.
Current Medical Research and Opinion, 2007
Background: The first Italian national guidelines were developed by the Italian Association of Urologists and published in 2007. Since then, a number of new drugs or classes of drugs have emerged for the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH), new data have emerged on medical therapy (monotherapies and combination therapies), new surgical techniques have come into practice, and our understanding of disease pathogenesis has increased. Consequently, a new update of the guidelines has become necessary. Methods: A structured literature review was conducted to identify relevant papers published between 1 August 2006 and 12 December 2010. Publications before or after this timeframe were considered only if they were recognised as important milestones in the field or if the literature search did not identify publications within this timeframe. The quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation framework.
Therapeutic Advances in Urology, 2012
Background: The first Italian national guidelines were developed by the Italian Association of Urologists and published in 2007. Since then, a number of new drugs or classes of drugs have emerged for the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH), new data have emerged on medical therapy (monotherapies and combination therapies), new surgical techniques have come into practice, and our understanding of disease pathogenesis has increased. Consequently, a new update of the guidelines has become necessary. Methods: A structured literature review was conducted to identify relevant papers published between 1 August 2006 and 12 December 2010. Publications before or after this timeframe were considered only if they were recognised as important milestones in the field or if the literature search did not identify publications within this timeframe. The quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation framework.