OBJECTIVES: 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.
OBJECTIVES: 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.
Authors: J Curtis Nickel; Carlos E Méndez-Probst; Thomas F Whelan; Ryan F Paterson; Hassan Razvi Journal: Can Urol Assoc J Date: 2010-10 Impact factor: 1.862
Authors: Nancy N Maserejian; Shan Chen; Gretchen R Chiu; Carrie G Wager; Varant Kupelian; Andre B Araujo; John B McKinlay Journal: Urology Date: 2013-07-19 Impact factor: 2.649