title: The natural history of lower urinary tract symptoms in black American men: relationships with aging, prostate size, flow rate and bothersomeness.
abstract: OBJECTIVE
  Studies of lower urinary tract symptoms in men have been restricted to predominately white populations and these observations may not be generalized to black American men. A goal of the Flint Men's Health Study was to evaluate the prevalence of lower urinary tract symptoms in a community based sample of black American men.
  
  
  METHODS
  We identified 721 eligible subjects after a 2-stage stratified sampling protocol of black American men residing in Flint, Michigan and an in-home interview. Of these men 364 (50%) completed the study protocol, including serum prostate specific antigen measurement, digital rectal examination, uroflowmetry and transrectal ultrasound. These men comprised our study group. Patients completed the American Urological Association (AUA) symptom and bothersomeness scores. Moderate to severe symptoms and impairment were defined as an AUA symptom score of greater than 7 and bothersomeness score of greater than 3, respectively. Data were stratified by 10-year age groups.
  
  
  RESULTS
  Prostate volume increased, while the peak urinary flow rate decreased with increasing age (p <0.001). Total AUA symptom and bothersomeness scores were marginally associated with age (p = 0.08 and 0.01, respectively). Although only 8.2% of the men reported an enlarged prostate and 3% reported being on medical therapy for benign prostatic hyperplasia, moderate to severe lower urinary tract symptoms were reported by 39.6% and moderate to severe impairment was present in 35%.
  
  
  CONCLUSIONS
  To our knowledge this is the first study to describe the prevalence of lower urinary tract symptoms and its associations with age, prostate size and peak flow rate in a black American population. A large proportion of the men in this study had from moderate to severe lower urinary tract symptoms, of whom many were undiagnosed and untreated. The AUA symptom score has the potential to identify these men and its validity in black Americans has now been established.
authors.affiliation: Department of Surgery-Urology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Wei
authors.forename: D
authors.initials: D
authors.lastname: Schottenfeld
authors.forename: K
authors.initials: K
authors.lastname: Cooper
authors.forename: J M
authors.initials: JM
authors.lastname: Taylor
authors.forename: G J
authors.initials: GJ
authors.lastname: Faerber
authors.forename: M A
authors.initials: MA
authors.lastname: Velarde
authors.forename: R
authors.initials: R
authors.lastname: Bree
authors.forename: J E
authors.initials: JE
authors.lastname: Montie
authors.forename: K A
authors.initials: KA
authors.lastname: Cooney
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000375:Aging / Q000502:physiology*; D001294:Attitude to Health; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications / Q000208:ethnology* / Q000503:physiopathology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics