Sj. Jacobsen et al., DO PROSTATE SIZE AND URINARY FLOW-RATES PREDICT HEALTH CARE-SEEKING BEHAVIOR FOR URINARY SYMPTOMS IN MEN, Urology, 45(1), 1995, pp. 64-69
Objectives. To estimate the association between health care-seeking be
havior for urinary dysfunction and clinical, physiologic, and anatomic
measures of disease. Methods. A randomly selected sample (n = 475) of
men aged 40 to 79 years from Olmsted County, Minnesota, was administe
red a previously validated questionnaire that assessed the frequency o
f and bother associated with urinary symptoms and health care-seeking
behavior in the past year. Peak urinary flow rates were measured with
a standard urometer and prostatic volume was determined by transrectal
ultrasound. Results. Overall, 21 of the 475 men (4%) had seen a docto
r in the past year for urinary symptoms. Men with moderate to severe s
ymptoms (American Urological Association [AUA] Symptom Scores >7) were
3.4 times as likely (95% confidence interval [CI] = 1.4, 8.3) to have
sought medical care in the past year as men with none to mild symptom
s. Men with enlarged prostates (>40 mL) were 3.9 times as likely to ha
ve sought health care (95% CI = 1.6, 9.6), whereas men with depressed-
peak urine flow rates (<10 mL/s) were only slightly more likely to hav
e sought health care for urinary symptoms (odds ratio = 2.1, 95% CI =
0.7, 6.5). Overall, 76% of men who had sought medical care had prostat
ic enlargement, depressed peak urine flow rates, or moderate-severe sy
mptoms (sensitivity). In contrast, only 55% of men who did not seek he
alth care for urinary symptoms in the past year had mild symptoms, nor
mal prostatic volume, and normal peak urine flow rates (specificity).
Conclusions. These data suggest that clinical, physiologic, and anatom
ic measures of prostatism do not adequately distinguish the men who se
ek medical care for their urinary symptoms from those who do not. Ther
e remain some factor(s) that apparently lead some men with minor disea
se to seek care and that prevent men with measurable disease from seek
ing care.