OBJECTIVES: To characterize the progression and treatment of lower urinary tract symptoms (LUTS) among men ages 45-69 years in the California Men's Health Study.
SUBJECTS/PATIENTS AND METHODS: 39,222 men ages 45-69 years from the Southern California Kaiser Permanente Health plan were surveyed in 2002-2003 and again in 2006-2007. Men who completed both surveys who did not have a diagnosis of benign prostatic hyperplasia (BPH) and were not on medications for LUTS at baseline were included (N=19,505). Among men with no or mild symptoms at baseline, incidence of moderate/severe LUTS (AUASI ≥ 8) and odds of progression to severe LUTS (AUASI ≥ 20) was estimated during 4 years of follow-up.
RESULTS: Of the 9,640 men who reported none/mild LUTS at baseline, 3,993 (41%) reported moderate-severe symptoms at follow-up and experienced a 4-point change in AUASI on average. Of them, 351 (8.8%) had a pharmacologic treatment, 8 (0.2%) had a minimally invasive or surgical procedure and 3,634 (91.0%) had no treatment recorded. Men who progressed to severe symptoms (AUASI ≥ 20) (n=165) were more likely to be on medication for BPH (OR=8.09, 95% CI= 5.77, 11.35), have a BPH diagnosis (OR=4.74, 95% CI=3.40, 6.61) or have seen a urologist (OR=2.49, 95% CI= 1.81, 3.43) when compared to men who did not progress to severe symptoms (AUASI < 20).
CONCLUSION: These data demonstrate that the majority of men who experienced progression did not have a pharmacologic or surgical therapy for their symptoms and therefore, may prove to be good candidates for a self-management plan.
Written by:
Wallner LP, Slezak JM, Loo RK, Quinn VP, Van Den Eeden SK, Jacobsen SJ. Are you the author?
Department of Medicine and Comprehensive Cancer Center, University of Michigan.
Reference: BJU Int. 2014 May 19. Epub ahead of print.
doi: 10.1111/bju.12810
PubMed Abstract
PMID: 24840926
