The natural history of lower urinary tract symptoms over five years.
OBJECTIVE
To assess the natural history of lower urinary tract symptoms (LUTS) in a cohort of previously untreated men over five years.


METHODS
Men participating in a health-screening project completed the International Prostate Symptom Score (IPSS) in 1996. In 2001, men older than 45 years with no prostate surgery or LUTS-specific medication before 1996 completed the IPSS plus a questionnaire on several aspects of LUTS. At the same time, all men underwent a health examination in 1996 and 2001.


RESULTS
A total 456 men aged 52+/-12 years (range: 40-84) at baseline completed the 5-year follow-up. Mean IPSS increased from 4.6 to 5.5 (+20%; p<0.0001) and the IPSS-Ql from 0.8 to 1.1 (+38%; p<0.0001) over five years. Progression of IPSS and IPSS-Ql were highly correlated. No change of IPSS was reported by 19%, a worsening by 50% and an improvement by 31%. Not all aspects of LUTS progressed in a similar pattern, storage symptoms had a higher tendency to improve over time. Medical therapy was initiated in 7%, 39% and 67% of those with mild, moderate or severe LUTS at baseline, respectively. In a multivariate analysis age and degree of being bothered by LUTS were independent predictors for initiation of therapy.


CONCLUSIONS
This 5-year longitudinal study of men without previous LUTS treatment demonstrates the slow nature of the disease's progression. Not all aspects of LUTS progress in a similar pattern. Initiation of therapy is influenced by patient age and by the degree of being bothered by LUTS.
Temml
Christian
C
Department of Preventive Health, City of Vienna, Vienna, Austria.
Brössner
Clemens
C
Schatzl
Georg
G
Ponholzer
Anton
A
Knoepp
Leise
L
Madersbacher
Stephan
S
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D016001:Confidence Intervals; D018450:Disease Progression; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D011470:Prostatic Hyperplasia / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014555:Urination Disorders / Q000175:diagnosis / Q000453:epidemiology*; D014570:Urologic Diseases / Q000175:diagnosis / Q000453:epidemiology