Abstract
BackgroundMost studies focusing on progression of BPH have been limited to the relationship between age and BPH progression, and only few studies have focused on the time duration to start treatment. This study aimed to investigate the association between self-perception period (S-PP) of lower urinary tract symptoms (LUTS) and International Prostate Symptom Score (IPSS).MethodsThis study used data from two large-population surveys: a community-based survey and a university hospital outpatient-based interview survey. Both surveys were conducted in male subjects aged 40 years or older who gave consent to the survey questionnaire and voluntarily expressed their intention to participate. Propensity score matching (PSM) was used to organize the population in both surveys into randomized groups to reduce selection bias. After excluding those who had missing values, 483 subjects were assigned to each group by PSM.ResultsThe S-PP of LUTS became significantly longer as the severity of LUTS increased. The S-PP was 4.15 years in the mild group, 4.36 years in the moderate group, and 6.23 years in the severe group. These differences were statistically significant. The correlation between S-PP of LUTS and IPSS was measured by partial correlation while controlling for age (correlation coefficient = 0.20, p <0.001). Multiple regression analysis after controlling for age revealed that one-year increase in the S-PP of LUTS significantly (p <0.001) increased IPSS by 0.322 points.ConclusionsThis study clarified the association between S-PP of LUTS and IPSS in a large-scale population. These findings suggest that, from the perspective of public health, S-PP is an important risk factor for LUTS progression.
Highlights
Most studies focusing on progression of Benign prostatic hyperplasia (BPH) have been limited to the relationship between age and BPH progression, and only few studies have focused on the time duration to start treatment
In order to enhance the validity of International Prostate Symptom Score (IPSS), both surveys excluded the following patients: 1) those who had undergone urological surgery which might affect their IPSS score; 2) those who had received any treatment for BPH or prostate cancer; 3) those who had evidence of neurological condition, uncontrolled diabetes mellitus, un-controlled hypertension, history of malignancy, urinary tract infection within 3 months, psychiatric illness with medications and alcohol or substance abuse; 4) those who were taking or had taken any drug for the same complaints
Characteristics of participants before and after Propensity score matching (PSM) With age and self-perception period (S-PP) of lower urinary tract symptoms (LUTS) as covariates, propensity scores were estimated as the probability of a hospital visit
Summary
Most studies focusing on progression of BPH have been limited to the relationship between age and BPH progression, and only few studies have focused on the time duration to start treatment. This study aimed to investigate the association between self-perception period (S-PP) of lower urinary tract symptoms (LUTS) and International Prostate Symptom Score (IPSS). Lower urinary tract symptoms (LUTS) of voiding and storage commonly affect middle-aged men. European EPIC study has estimated that LUTS is present in 62.5% of middle-aged men (voiding symptoms, 25.7%; storage symptoms, 51.3%) [1]. Korean EPIC study has estimated that LUTS is present in 53.7% of middle-aged men (voiding symptoms, 28.5%; storage symptoms, 44.6%) [2]. Benign prostatic hyperplasia (BPH), often causes voiding symptoms, a highly prevalent condition in middleaged men. BPH does not suddenly appear as a disease. It develops slowly in a natural process after subjective
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