title: Risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in a community based population of healthy aging men: the Krimpen Study.
abstract: OBJECTIVE
  We explored risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in the open population.
  
  
  METHODS
  A longitudinal, population based study with a followup of 6.5 years was done in 1,688 men who were 50 to 78 years old. Data were collected on transrectal ultrasound of prostate volume, urinary flow rate, ultrasound estimated post-void residual urine volume, generic and disease specific quality of life, and symptom severity based on the International Prostate Symptom Score. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia were defined as an International Prostate Symptom Score of greater than 7 after a report of a score of less than 7 in the previous round. A multivariate Cox proportional hazard model was constructed to determine risk factors for clinical benign prostatic hyperplasia after correcting for patient age.
  
  
  RESULTS
  Total followup was 4,353 person-years. During followup 180 events of attaining an International Prostate Symptoms Score of greater than 7 occurred. Multivariate analysis showed that functional bladder capacity, post-void residual urine volume, treatment for cardiac diseases, education level, antidepressant use, calcium antagonist use, erectile function or dysfunction, prostate specific antigen and a family history of prostate cancer were determinants with a significant HR.
  
  
  CONCLUSIONS
  In addition to age, we established 9 significant determinants for lower urinary tract symptoms suggestive of benign prostatic hyperplasia. However, not all risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia are accounted for since we can conclude that 1 of 3 men without these risk factors will still be diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia between ages 50 and 80 years.
authors.affiliation: Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands. e.t.kok-2@umcutrecht.nl
authors.forename: Esther Tanja
authors.initials: ET
authors.lastname: Kok
authors.forename: Boris W
authors.initials: BW
authors.lastname: Schouten
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Bohnen
authors.forename: Frans P M W
authors.initials: FP
authors.lastname: Groeneveld
authors.forename: Siep
authors.initials: S
authors.lastname: Thomas
authors.forename: J L H Ruud
authors.initials: JL
authors.lastname: Bosch
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D000704:Analysis of Variance; D015331:Cohort Studies; D003937:Diagnosis, Differential; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011336:Probability; D016016:Proportional Hazards Models; D011470:Prostatic Hyperplasia / Q000175:diagnosis* / Q000453:epidemiology*; D012016:Reference Values; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D036761:Ultrasound, High-Intensity Focused, Transrectal; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis* / Q000453:epidemiology; D014555:Urination Disorders / Q000175:diagnosis* / Q000453:epidemiology; D014563:Urodynamics