Clinical Characteristics Of Geriatric Outpatient With Benign Prostate Hyperplasia (BPH) In Urban China And The Influencing Factors Of I-PSS

OBJECTIVES:To understand the demographical and clinical characteristics and severity of obstructive symptoms of patient with benign prostate hyperplasia (BPH), and to analyze the impacting and related factors of the severity of lower urinary tract symptoms (LUTS), namely I-PSS, in order to provide scientific and reliable basis for clinical diagnosis of BPH.METHODS:Stratified randomized sampling was applied to recruit the patients.19cities from13province, were selected randomly.Outpatient departments of geriatrics in3first-class hospitals were selected from each city. Patients who visit the department and are older than50were selected randomly to meet the estimated sample size. A total of3921cases were investigated;2521of which were from economically developed cities and the other1400were from developing cities. Date was colleted through the self-designed "questionnaire of patients with Benign Prostate Hyperplasia in Geriatric Outpatient".RESULTS:1. Demographical characteristicsThe average age of patients with BPH was74.9±9.9, and the proportions of certain occupation, marriage, education level and income were:43.5%(1640) administrators,98.4%(3662) married,67.0%(2518) high-school or higher degree,48.9%(1919) income between2000and5000, respectively. All above items are significantly different between patients from economically developed and developing cities (P<0.001). 2. Clinical characteristics of patients64.3%(2523) patients had hypertension history. Disease related characteristics were:5.6±4.7years disease duration,5.2±4.3years medication duration,38.8±16.7ml prostate volume,16.9±8.9ml/s maximum flow rate (Qmax),208.7±61.3ml total urine volume (TUV),2.3±0.9ng/ml (as medium) serum prostate-specific antigen (PSA),25.0±39.0ml (as medium) postvoid residual volume (PRV),18.8±5.9international prostate symptom score (I-PSS), and3.7±1.0quality of life (QOL), respectively.96.8%patients were treated with medicine.5-reductase inhibitors was most used (92.9%), and combined medication accounted for73.0%. Urinary tract infection was the most occurred complication disease (21.2%).3. Risk factors of the severity of LUTS in patients with BPHUnivariate analysis showed that the severity of LUTS were significantly different among cities of different economical status, different ages, marriage situations, occupations, education levels and monthly income (P<0.001). Ordinal logistic regression showed that worse economical status of city (OR=1.767), older in age (OR=1.385), working as professionals (OR=1.235), and education level of high school or higher degree (OR=1.171) were risk factors. Namely, patients with these traits were more likely to suffer more severe LUTS.Stepwise multiple linear regression for factors of I-PSS showed that QOL, Qmax and PV were impacting factors of I-PSS, determination coefficient of regression model was53.9%and path analysis identified insignificant multicolinearity in this model.CONCLUSIONS:The average age of patients was74.9years. The main distribution of I-PSS was with moderate to severe. The severity of LUTS are correlated to age, economical status, occupation, education level, QOL, Qmax and PV.