title: The long-term relationship between a real change in prostate volume and a significant change in lower urinary tract symptom severity in population-based men: the Krimpen study.
abstract: OBJECTIVE
  We used the database of a longitudinal community-based study to investigate whether real changes in prostate volume (PV) (ie, changes greater than the combination of intra- and interobserver variation of volume measurement) corresponded with significant changes in symptom severity.
  
  
  METHODS
  In a community-based study of men aged 50-78 yr, the International Prostate Symptom Score (IPSS) and PV were measured at baseline and at 4.2-yr follow-up. Of 1417 men, 864 completed both rounds. A significant change in IPSS was defined as a change of > or = 4 points. A real change in PV was defined as a percent change of > or = 26%, or an absolute change of > or = 10 cc.
  
  
  RESULTS
  After 4.2 yr, about 20% of the men had experienced a significant increase in IPSS and 16-23% had a real increase in PV. The age-adjusted odds ratio for a significant increase in symptom severity, which contrasts men who have a real increase in PV and men who do not show such an increase, is 1.38 (95%CI, 1.05-1.85]. The age-adjusted odds ratio for a significant decrease in symptom severity, which contrasts men with a real increase in PV and those without such an increase, is 1.50 (95%CI, 1.11-2.85).
  
  
  CONCLUSIONS
  Benign prostatic hyperplasia can be characterised as a progressive disease in a certain proportion of men older than 50 yr. Men with growing prostates are at a greater risk of symptomatic deterioration. Men who have prostates that do not grow significantly are more likely to improve symptomatically.
authors.affiliation: Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands. j.l.h.r.bosch@umcutrecht.nl <j.l.h.r.bosch@umcutrecht.nl>
authors.forename: J L H Ruud
authors.initials: JL
authors.lastname: Bosch
authors.forename: Chris H
authors.initials: CH
authors.lastname: Bangma
authors.forename: Frans P M J
authors.initials: FP
authors.lastname: Groeneveld
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Bohnen
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D018450:Disease Progression; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000473:pathology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014463:Ultrasonography