OBSTRUCTIVE PROSTATIC SYMPTOMS - A COMMUNITY SURVEY IN JERUSALEM

Background. Benign prostatic hypertrophy has a high prevalence in men aged greater than or equal to 50, but there is little information on t he correlates of obstructive symptoms. Methods. The prevalence and cor relates of reported prostatic symptoms in men aged greater than or equ al to 50 years were studied in a community survey in the Kiryat Hayove l neighbourhood of Jerusalem in 1985-1987. Five prostate-related quest ions were asked. Two indices of emotional health were used: the Psychi atric Epidemiology Research interview demoralization scale and a scale based on the Cornell Medical Index. Associations with sociodemographi c, behavioural, emotional, biochemical and physical variables and with self-appraised health were examined both controlling for age only and by multivariate logistic regression. Results. The prevalence rates in the 839 respondents were 20.4% for hesitancy, 41.1% for weak stream, and 26.7% for terminal dribbling; the rates tended to increase with ag e. The associations between the symptoms (controlling for age) were si gnificant, the strongest being between hesitancy and weak stream. All three of the urinary symptoms were associated with indices of emotiona l distress. In the multivariate analysis, the odds ratios when men in the highest and lowest quartiles of emotional ill health were compared were 3.0 for hesitancy, 2.2 for weak stream, and 3.8 for dribbling. S pecific symptoms were associated with blood pressure, social class and educational level. Conclusion. The striking associations with emotion al iii health underline the importance of appropriate attention to the emotional health of patients who complain of prostatic symptoms.