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• W4243428596 abstract "Many older men now recognize that there are noninvasive treatments for benign prostatic hyperplasia (BPH) and are seeking medical advice for their lower urinary tract symptoms (LUTS) suggestive of BPH (LUTS/BPH). Both storage symptoms (frequency, nocturia, urgency, and urinary urge incontinence—also known as overactive bladder) and voiding symptoms are seen. The storage symptoms are particularly bothersome to the patient because they cause embarrassment and interfere with daily activities. 1 Donovan J.L. Kay H.E. Peters T.J. et al. Using the ICSQOL to measure the impact of lower urinary tract symptoms on quality of life evidence from the ICS-BPH study. Br J Urol. 1997; 80: 712-721 Crossref PubMed Google Scholar In the early 1990s, 2 community-based studies in Scotland and the United States showed that LUTS/BPH (usually defined as a total International Prostate Symptom Score [I-PSS] ≥7) occurs in approximately 25% of men aged ≥40 years and that the prevalence increases with increasing age. 2 Garraway W.M. Collins G.N. Lee R.J. High prevalence of benign prostatic hypertrophy in the community. Lancet. 1991; 338: 469-471 Abstract PubMed Scopus (669) Google Scholar , 3 Chute C.G. Panser L.A. Girman C.J. et al. The prevalence of prostatism a population-based survey of urinary symptoms. J Urol. 1993; 150: 85-89 Abstract Full Text PDF PubMed Scopus (608) Google Scholar More recently, an analysis of the General Practice Research Database (GPRD) in the United Kingdom, which contains anonymized records covering a population of about 4.6 million patients, showed that the incidence of LUTS/BPH increased linearly from the ages of 45 to 85 years (r2 = 0.992). 4 Logie J.W. Clifford G.M. Farmer R.D.T. et al. Lower urinary tract symptoms suggestive of benign prostatic obstruction Triumph—the role of general practice databases. Eur Urol. 2001; 39: 42-47 Crossref PubMed Scopus (34) Google Scholar , 5 Farmer R. Clifford J.G. Incidence and prevalence of LUTS/BPH in the UK in the 1990s. BJU Int. 2002; 90 (Abstract UP-1.3.07): 74 Google Scholar The prevalence of LUTS/BPH increased from 2.5% at the age of 45 to around 35% for men aged 80 to 89 years. 5 Farmer R. Clifford J.G. Incidence and prevalence of LUTS/BPH in the UK in the 1990s. BJU Int. 2002; 90 (Abstract UP-1.3.07): 74 Google Scholar Similar findings were reported by a retrospective cohort study, which used the Integrated Primary Care Information (IPCI) database containing medical records from 80,774 men registered with Dutch general practitioners. 6 Verhamme K.M. Dieleman J. Bleumink G. et al. Incidence and prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in primary care latest analyses from the Triumph project. J Urol. 2002; 167 (Abstract 1073): 273 Google Scholar The overall prevalence of LUTS/BPH (defined as a diagnosis of BPH, treatment or surgery with the indication of BPH, or presence of symptoms suggestive of BPH) was 10% and increased from 2.7% in men aged 45 to 49 years to 24% in men aged 80 years. The overall incidence was 15 per 1000 man-years, with a linear increase with age up to age 80 (r2 = 0.99): 3 per 1000 man-years for men aged 45 to 49 years to 38 per 1000 man-years for men aged 75 to 79 years. After the age of 80 years the incidence remained constant, which may be explained by the select population of patients that were still in the cohort. A multicenter, prospective epidemiologic survey conducted among 2200 French general practitioners evaluated 18,540 men ≥50 years without previous LUTS/BPH (defined by I-PSS ≥8, I-PSS quality of life [QOL] ≥3, or a clinical diagnosis) seeking medical advice for a reason other than urologic complaints. 7 Flam T.A. Morinet P. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia, an underdiagnosed disease in general practice a French epidemiological study. J Urol. 2002; 167 (Abstract 1057): 269 Google Scholar It was demonstrated that almost 50% of these men had moderate LUTS/BPH (mean I-PSS, 14.1 ± 4.7) and impairment of QOL. The fact that the prevalence in the GPRD and IPCI databases was lower than in the community-based surveys may be explained by the GPRD and IPCI databases only including patients who visited their general practitioner because of urinary symptoms, whereas in the community-based surveys, all men with a certain level of urinary symptoms were considered, whether or not they consulted a physician because of these symptoms. When the French patients with LUTS/BPH were asked how they would feel if they had to spend the rest of their life with their urinary condition “just the way it is now,” 70% of them indicated that they were at least mostly dissatisfied. 7 Flam T.A. Morinet P. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia, an underdiagnosed disease in general practice a French epidemiological study. J Urol. 2002; 167 (Abstract 1057): 269 Google Scholar Although these patients were obviously significantly bothered by their condition, they had not sought medical advice or talked about their problems. As seen in Figure 1, the major reason for this was that they attributed their symptoms to aging (70%). In addition, patients feared prostatic surgery (48%) and were often ashamed (32%). 7 Flam T.A. Morinet P. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia, an underdiagnosed disease in general practice a French epidemiological study. J Urol. 2002; 167 (Abstract 1057): 269 Google Scholar" @default.
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• W4243428596 date "2003-09-01" @default.
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• W4243428596 title "Introduction" @default.
• W4243428596 doi "https://doi.org/10.1016/s0090-4295(03)00497-7" @default.
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