LUTS, ED, QOL: alphabet soup or real concerns to aging men?

The severity of symptoms and the degree to which they negatively impact on quality of life (QOL) are the major factors prompting patients with benign prostatic hyperplasia (BPH) to seek treatment. Several tools have been developed to assess symptom severity in patients with BPH, including the International Prostate Symptom Score (IPSS), the Danish Prostate Symptom Score (DAN-PSS), and the International Continence Society (ICS) questionnaire. Data from the Veterans Affairs Cooperative Study show that reductions in IPSS scores predict global ratings of improvement with treatment. Instruments have also been developed to measure the impact of urinary symptoms on QOL and have shown that as symptom severity increases, the impact on QOL also increases. Data from studies conducted in the United States, France, Scotland, and Japan reveal a similar pattern regarding the impact of symptom severity on QOL. Studies have also demonstrated that medical treatment with alpha-blockers, for example, is associated with a reduction in symptoms and a corresponding improvement in QOL. Patients with BPH frequently also have coexisting erectile dysfunction, which significantly affects QOL. Thus, in addition to assessment of symptoms and QOL in patients with BPH, sexual function should also be assessed in these patients.