Prevalence of lower urinary tract symptoms and self-reported diagnosed 'benign prostatic hyperplasia', and their effect on quality of life in a community-based surrey of men in the UK

Objectives To assess the prevalence of lower urinary tract symptoms (LUTS) in a community-based population in the UK, to measure the impact of these s ymptoms on quality of life and health status in men with self-reported 'ben ign prostatic hyperplasia' ('BPH')I and to evaluate health-seeking behaviou r in this population. Subjects and methods A postal survey was distributed to an age-stratified r andom sample of 1500 men aged 50 years or older from throughout England, Sc otland and Wales, The self-administered survey included: demographic questi ons: the EuroQoL (EQ-5D) instrument, consisting of a health-status index qu estionnaire and a visual analogue scale (VAS) on which participants rated t heir current health status; the International Prostate Symptom Score (IPSS) questionnaire: and a questionnaire assessing the participants health-seeki ng behaviour and awareness of BPH. Results Responses to the survey were received from 1115 (74%) of the 1500 m en. Overall, 41% (450/ 1088) had an IPSS of greater than or equal to 8, ind icating moderate-to-severe LUTS, yet only 196 men (18%) reported that they had been diagnosed with 'BPH'. Both quality of life (as measured by the EQ- 5D) and general health status (as measured by the VAS) decreased as urinary symptom severity increased, and the greater the severity, the more men who reported a problem with mobility, self-care, usual activity, pain/discomfo rt, and anxiety/depression (the fire domains of the EQ-5D). The possibility of symptoms worsening appeared to be the key determinant in the respondent s' decisions to consult a medical professional for their LUTS. Less than 11 % of the respondents were aware of the availability of specific prescriptio n drug therapies or surgical options for the treatment of 'BPH'. The most c ommon first treatment strategy for those consulting for symptoms was watchf ul waiting (34%) followed by surgery (30%) and prescription drugs (21%). Conclusions Moderate-to-severe LUTS were relatively common in this UK popul ation of men over the age of 50, yet relatively few had been diagnosed with 'BPH'. As LUTS adversely affect quality of life, improved treatment option s and increased public awareness of BPH and LUTS are needed to combat a pro blem facing the growing number of elderly men in the population.