Progression and treatment of incident lower urinary tract symptoms (LUTS) among men in the California Men's Health Study.
OBJECTIVE
To characterise the progression and treatment of lower urinary tract symptoms (LUTS) among men aged 45-69 years in the California Men's Health Study.


METHODS
A total of 39,222 men, aged 45-69 years, enrolled in the Southern California Kaiser Permanente Health Plan were surveyed in 2002-2003 and again in 2006-2007. Those men who completed both surveys who did not have a diagnosis of benign prostatic hyperplasia (BPH) and were not on medication for LUTS at baseline were included in the study (N = 19,505). Among the men with no or mild symptoms at baseline, the incidence of moderate/severe LUTS (American Urological Association Symptom Index [AUASI] score ≥8) and odds of progression to severe LUTS (AUASI score ≥20) was estimated during 4 years of follow-up.


RESULTS
Of the 9640 men who reported no/mild LUTS at baseline, 3993 (41%) reported moderate/severe symptoms at follow-up and experienced a 4-point change in AUASI score on average. Of these men, 351 (8.8%) had received a pharmacological treatment, eight (0.2%) had undergone a minimally invasive or surgical procedure and 3634 (91.0%) had no treatment recorded. Men who progressed to severe symptoms (AUASI score ≥20; n = 165) were more likely to be on medication for BPH (odds ratio [OR] 8.09, 95% confidence interval [CI] 5.77-11.35), have a BPH diagnosis (OR 4.74, 95% CI 3.40-6.61) or have seen a urologist (OR 2.49, 95% CI 1.81-3.43) when compared with men who did not progress to severe symptoms (AUASI score <20).


CONCLUSIONS
These data show that the majority of men who experienced progression did not have pharmacological or surgical therapy for their symptoms and, therefore, may prove to be good candidates for a self-management plan.
Department of Medicine and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA.
Lauren P
LP
Wallner
Jeff M
JM
Slezak
Ronald K
RK
Loo
Virginia P
VP
Quinn
Stephen K
SK
Van Den Eeden
Steven J
SJ
Jacobsen
D000328:Adult; D000368:Aged; D002140:California / Q000453:epidemiology; D018450:Disease Progression; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011470:Prostatic Hyperplasia
benign prostatic hyperplasia; incidence; lower urinary tract symptoms; progression