Factors related to delayed treatment and posttreatment symptom severity inTaiwanese patients with benign prostatic hyperplasia

We evaluated the sociodemographic and clinical factors of delayed treatment and posttreatment symptom severity in outpatients with benign prostatic hy perplasia (BPH). The study included 146 BPH patients treated at the Nationa l Taiwan University Hospital in early 1997. All patients were treated with alpha-adrenergic antagonists or finasteride for at least 2 weeks. A questio nnaire based on Andersen's Health Behavior Model was used to assess various sociodemographic features, while the pre- and posttreatment symptoms sever ity was rated according to the International Prostate Symptom Score (IPSS). Multiple logistic regression was used to assess the associations of these factors with delayed treatment and posttreatment symptom severity. Subjects who had recently quit smoking or were blue-collar workers tended to delay treatment, while those who chose a medical center as the care provider for chronic diseases tended to be less likely to delay treatment. However,none of these associations were statistically significant. No enabling factors ( income, insurance) or need factors (symptom scores) evaluated were associat ed with delayed treatment. Predisposing factors associated with higher post treatment symptom severity were delayed treatment (over 12 months) (adjuste d odds ratio [OR]: 2.67, 95% confidence interval [CI]: 1.16-6.16),quitting smoking (adjusted OR: 4.47, 95% CI: 1.34-14.94),and having never smoked (ad justed OR: 3.73, 95% CI: 1.15-12.11). Subjects with severe pretreatment sym ptoms were far more likely than subjects with mild pretreatment symptoms to have severe symptoms after treatment (adjusted OR: 52.69, 95% CI: 54.46-62 1.90). Our findings, though based on a limited number of subjects, suggest sociodemographic factors rather than objective clinical attributes (prostat e specific antigen level, prostate volume, and urodynamic results) are asso ciated with delayed treatment in Taiwanese men with BPH. Both pretreatment symptom severity and sociodemographic factors are related to posttreatment symptom severity.