Progression of Null or Mild Lower Urinary Tract Symptoms Indicative of Benign Prostatic Hyperplasia After 2 Years of Follow-up in Non-treated Men Aged 40 Years or Older

Abstract

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. 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. 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 = .01) and armed forces, qualified agriculture and fishing workers (OR, 4.11; P = .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 = .008) was related to a lower frequency of progression than the same alcohol intake in men younger than 50 years (OR, 2.03; P = .380). 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.