Prevalence of LUTS and Self Reported BPH and their Impact on Health Related Quality of Life of the Elderly

Aravind Babu P .

Abstract


BACKGROUND - Despite higher rates of prevalence of BPH (Benign Prostatic Hyperplasia) in elderly, it is grossly underestimated due to a variety reasons. The main burden of BPH is manifested as a reduction in the Health Related Quality of Life (HRQoL) rather than the consumption of healthcare resources. AIMS AND OBJECTIVES - The objectives of this study are to assess the prevalence of LUTS and self reported BPH in the elderly population, to measure the impact of these symptoms on HRQoL and health status and to evaluate their awareness about the treatment options a n d t h e i r t r e a t m e n t s e e k i n g b e h a v i o u r . METHODOLOGY - The study group included elderly male over 65 years of age with LUTS and those previously diagnosed with BPH in a tertiary care centre. The study methods employed were 1) IPSS (International Prostate Symptom Score) questionnaire 2) EuroQoL (EQ-5D) consisting of a health status index questionnaire and a Visual Analogue Scale (VAS) and 3) Questionnaire to assess the participants' treatment seeking behaviour and awareness of BPH. RESULTS – of the 220 men surveyed, 41 percent (90 men) had an IPSS greater than or equal to 8 indicating moderate to severe LUTS, yet only 19.5 percent (43 men) reported that they had been diagnosed with BPH. Both health related quality of life (as measured by EQ-5D) and general health status (as measured by VAS) decreased, as the severity of urinary symptoms increased. The possibility of symptoms worsening appeared to be the key determinant in the respondents' decision to seek medical care for LUTS and only 4 percent were aware of the specific treatment options for BPH. CONCLUSION - Moderate to severe LUTS is common in elderly men over 65 yrs of age, yet relatively a few had been diagnosed with BPH. As LUTS adversely affects the quality of life, improved treatment options and increased public awareness of BPH and LUTS are needed to combat the problem faced by the growing number of elderly men in the population.

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References


Guess HA. Epidemiology and natural history of benign prostatic hyperplasia. Urol Clin North Am1995; 22: 247±61

Birkhoff JD, Wiederhorn AR, Hamilton ML, Zinsser HH. Natural history of benign prostatic hypertrophy and acute urinary retention. Urology 1976; 7: 48±52

Barry MJ. Epidemiology and natural history of benign prostatic hyperplasia. Urol Clin North Am1990; 17: 495±507

Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet 1991; 338: 469±71.

Oesterling JE. Benign prostatic hyperplasia. Medical and minimally invasive treatment options. N Engl J Med 1995; 332: 99±109

Simpson RJ, Fisher W, Lee AJ, Russell EB, Garraway M. Benign prostatic hyperplasia in an unselected community- based population: a survey of urinary symptoms, bothersomeness and prostatic enlargement. Br J Urol 1996; 77: 186±91

Bosch JL, Hop WC, Kirkels WJ, Schroder FH. Natural history of benign prostatic hyperplasia; appropriate case definition and estimation of its prevalence in the community. Urology 1995; 46: 34±40

Britton JP, Dowell AC, Whelan P. Prevalence of urinary symptoms in men over 60. Br J Urol 1990; 66: 175±6

Drummond MF, McGuire AJ, Black NA, Petticrew M, McPherson CK. Economic burden of treated benign prostatic hyperplasia in the United Kingdom. Br J Urol 1993; 71: 290±6

Oesterling JE. Benign prostatic hyperplasia: a review of its histogenesis and natural history. The Prostate (Suppl) 1996; 6:67±73

The EuroQol Group. EuroQol Ð a new facility for the measurement of health related quality of life. Health Policy 1990; 16: 199±208

Brazier J, Jones N, Kind P. Testing the validity of the EuroQo

l and comparing it with the SF- 36 health survey questionnaire. Qual Life Res 1993; 2: 167±8

Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A. Measuring health related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D). Br J Rheumatol 1997; 36: 551±9

Barry MJ, Fowler FJ Jr, O'Leary MP et al. The American Urological Association Symptom Index for benign prostatic hyperplasia. J Urol 1992; 148: 1549±57

Barry MJ, Fowler FJ, O'Leary MP et al. Correlation of the American Urological Association Symptom Index with self- administered versions of the Madsen-Iversen, Boyarsky and Maine Medical Assessment Program Indexes. J Urol 1992;148:1558±63

Cockett AT, Aso Y et al. Recommendation of the International Consensus Committee on prostate symptom score and quality of life assessment. In Cockett ATK, Khoury S, Aso Y et al., eds. Proceedings of the 2nd International Consultation on Benign Prostatic Hyperplasia (BPH) Paris: Scientific Communication International Ltd, 1994: 553±5

Homma Y, Kawabe K, Tsukamoto T et al. Epidemiologic survey of lower urinary tract symptoms in Asia and Australia using the International Prostate Symptom Score. Int J Urol 1997; 4: 40±6

Sagnier PP, Girman CJ, Garraway M et al. International comparison of the community prevalence of symptoms of prostatism in four countries. Eur Urol 1996; 29: 15±20.


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