An Epidemiological Survey Of LUTS/BPH Of Older Men In A Community In ChengDu

Purpose: To well know the prevalence and presentation of LUTS/BPH of older men in a community; analyze the significance and correlation of IPSS,QoL,TPV, PSA, PSAD,Qmax, PVR,NIH-CPSI and IIEF-5;and study the effectiveness of routine test of expressed prostatic secretion in older men.Materials and Methods: According to the selective standard, we selected 171 men 50 to 79 years in a community in ChengDu in October 2003. We collected their general information including height, weight, history of hypertension, smoking, drinking, and helped them complete the questionnaires of IPSS, QoL, NIH-CPSI and IIEF-5. At the same time, they underwent some examinations, such as routine test of middle urine and EPS, serum prostate specific antigen (PSA), uroflowmetry, transabdominal ultrasonography for prostate and post-voiding residual, and digital rectal examination. They were grouped according to age, EPS-WBC count, IIFE-5 score, body mass index (BMI), hypertension, smoking and drinking. We analyzed the difference and correlation of these data by SPSS 11.0.Results: 1, In our study, the prevalence of BPH is 67.3% when we takeTPV>20ml and IPSS>7 or Qmax<15ml / s as the diagnostic criteria for BPH, and 50-59 years 60%, 60-69 years 62.6%, 70-79 years74.3%. TPV ( r=0.198,P=0.010 ) , PSA(r=0.224,P=0.003), PVR(r=0.180,P=0.020), Qmax(r=-0.197 , P=0.010), IffiF5(r=-0.337,P=0.000) et al, all have correlation with age. 2, The prevalence of moderate-to-severe LUTS (IPSS^ 8) is 49.1%, and 50-59 years 50%, 60-69 years 44%, 70-79 years 55.7%. In IPSS, nocturia score (332) is the highest, followed by weak urinary stream (262), and urgency score(108) is the lowest. IPSS has significant correlation with QoL: r=0.664, P=0.000. 3, In our study, the prevalence of EPS-WBC number^ 1 I/HP is 23.4%, and 50-59 years 20%, 60-69 years 23.1%, 70~79years24.3%. 4, IPSS has significant correlation with NTH-CPSI(r=0.773,P=0.000), NM-CPSFS pain score (r=0.198,P=0.009), NIH-CPSFS urinary symptom score (r=0.790,P=0.000), MH-CPSI'S quality of life impact score (r=0.655,P=0.000). 5,The older men were divided into three groups according to EPS-WBC count. There was no difference of age in all three groups. All means of IPSS, QoL, TPV, PSA and PVR in EPS-WBC count 5-10 group were higher than other tow groups, yet Qmax' is lower. There were some difference between these data, especially TPV (F=4.853,P=0.009) . 6, The mean of nocturia score in hypertension group is 2.54, yet it is 1.77 in non-hypertension, there is significant difference between tow groups (t=-3.498 P=0.001) . The mean of IPSS in smoking group is 10.17, it is 7.49 in non-smoking, the difference is also significant(t=-2.495,P=0.014) . Conclusions:1, BPH is a common benign disease in older men, it's prevalence andclinical symptoms are progressing with aging. In our study, the prevalence of BPH is 67.3%.2, hi LUTS of older men, the score of nocturia is the highest, and the voiding symptoms are more severe than storage symptoms.3, For the older men, there is overlap between IPSS and NIH-CPSI score, and the main overlap lies in LUTS.4, hi the older men, the prevalence of subclinical chronic prostatitis is 23.4% in our study, and it is sometimes combined with BPH. Therefore, it is necessary to pay attention to their interaction in clinical diagnosis and therapy.5, Our findings indirectly support that inflammatory process in prostate has a potential role in the pathogenesis of BPH. It is worthwhile to research their relationship.6, Our study shows: sexual activity, BMI and alcohol may have little correlation with BPH; smoking probably aggravates the LUTS of older man; nocturia is more severe in BPH combined with hypertension.