Prevalence of lower urinary tract symptoms and self‐reported diagnosed ‘benign prostatic hyperplasia’, and their effect on quality of life in a community‐based survey of men in the UK

Abstract

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 symptoms on quality of life and health status in men with self-reported ‘benign prostatic hyperplasia’ (‘BPH’), and to evaluate health-seeking behaviour in this population. Subjects and methods A postal survey was distributed to an age-stratified random sample of 1500 men aged 50 years or older from throughout England, Scotland and Wales. The self-administered survey included: demographic questions; the EuroQoL (EQ-5D) instrument, consisting of a health-status index questionnaire and a visual analogue scale (VAS) on which participants rated their current health status; the International Prostate Symptom Score (IPSS) questionnaire; and a questionnaire assessing the participants’ health-seeking behaviour and awareness of BPH. Results Responses to the survey were received from 1115 (74%) of the 1500 men. Overall, 41% (450/ 1088) had an IPSS of ≥8, indicating 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/discomfort, and anxiety/depression (the five domains of the EQ-5D). The possibility of symptoms worsening appeared to be the key determinant in the respondents’ decisions to consult a medical professional for their LUTS. Less than 11% of the respondents were aware of the availability of specific prescription drug therapies or surgical options for the treatment of ‘BPH’. The most common first treatment strategy for those consulting for symptoms was watchful waiting (34%), followed by surgery (30%) and prescription drugs (21%). Conclusions Moderate-to-severe LUTS were relatively common in this UK population of men over the age of 50, yet relatively few had been diagnosed with ‘BPH’. As LUTS adversely affect quality of life, improved treatment options and increased public awareness of BPH and LUTS are needed to combat a problem facing the growing number of elderly men in the population.