THE IMPACT OF LOWER URINARY-TRACT SYMPTOMS ON GENERAL HEALTH-STATUS AND ON THE USE OF PROSTATECTOMY

Our objective was to determine the extent to which lower urinary tract symptoms affect the general health status of men and contribute to th e decision to undergo surgery, A cross-sectional population survey usi ng postal questionnaires was conducted in the North West Thames health region, followed by a prospective cohort study of men undergoing pros tatectomy (North West Thames and Oxford regions), The subjects in the first survey were 221 men aged 55 and over with previously reported mi ld, moderate or severe urinary symptoms; subjects in the second study were 388 men undergoing prostatectomy, Main outcome measures were self -reported symptom severity, bothersomeness and general health status ( Nottingham Health Profile, Part 1), The response rate among eligible r esponders in the population survey was 85.7%, Increasing symptom sever ity was associated with worsening NHP scores for energy, emotional rea ctions, sleep and physical mobility (p < 0.01), Increasing bothersomen ess of symptoms was associated with emotional reactions, sleep and pai n (p < 0.05), Men undergoing surgery reported worse health status than men in the population with the same severity of symptoms as regards e motional reactions, energy and pain. For a given level of symptom seve rity, the impact of those symptoms on aspects of a man's general healt h status may be the determinant of seeking and undergoing surgery, Gre ater understanding of the factors that affect a man's response to his symptoms is needed in interpreting the decision to seek and accept tre atment.