Natural history of lower urinary tract symptoms in men—result of a longitudinal community-based study in Japan

Abstract

Objectives To investigate the longitudinal changes in the International Prostate Symptom Score (IPSS), bother score, and quality-of-life index in a community-based study in Japan. Methods Of 289 men between 40 and 79 years of age who were analyzed in the first community-based study, 223 (77.2%) participated in a follow-up study conducted 3 years later. The IPSS, bother score, and quality-of-life index, as well as medical histories and current medication use, were evaluated. Results Neither the average IPSS, bother score, nor quality-of-life index significantly changed after 3 years in any age decade. However, changes in the IPSS varied among individuals, because 32%, 35%, and 33% of the men reported improved, stable, and worsened IPSS, respectively. Transurethral resection of the prostate was performed on 0%, 4%, and 21% of the men in the mild (0 to 7), moderate (8 to 19), and severe (20 to 35) IPSS categories, respectively. Neither prostate volume nor peak urinary flow rate significantly predicted progression of the IPSS after 3 years. Conclusions Although no definite general symptomatic progression was observed in the participants during 3 years, changes in subjective urinary symptoms varied among individuals ranging from improvement to worsening. The men with a more severe IPSS had a greater chance of transurethral resection of the prostate within 3 years.