Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia.

In previous studies the severity of symptoms of prostatism in men with benign prostatic hyperplasia have not correlated well with prostate size, degree of bladder trabeculation, uroflowmetry or post-void residual volume. As part of a prospective cohort study of benign prostatic hyperplasia treatment effectiveness in 4 university-based urology practices, we correlated symptom severity and these commonly used measures of disease severity. Symptom severity was quantified using the American Urological Association symptom index. Analyses were based on 198 outpatients completing a standardized evaluation (84 of these men have completed 6 months of followup after treatment with prostatectomy, balloon dilation, terazosin or watchful waiting). At baseline, symptom severity was not correlated with uroflowmetry, post-void residual, prostate size and degree of bladder trabeculation. However, symptom severity was much more strongly related to overall health status than the other measures. Reduction in symptoms with treatment did correlate with improvements in uroflowmetry. This poor baseline correlation with symptoms may reflect unreliability in measurement of the physiological/anatomical variables. Alternatively, these parameters may be measuring different pathophysiological phenomena.

[1]  K. Jensen,et al.  Spontaneous uroflowmetry in prostatism. , 1984, Urology.

[2]  P. Walsh,et al.  The effect of nafarelin acetate, a luteinizing-hormone-releasing hormone agonist, on benign prostatic hyperplasia. , 1987, The New England journal of medicine.

[3]  P. Abrams,et al.  The assessment of prostatic obstruction from urodynamic measurements and from residual urine. , 1979, British journal of urology.

[4]  P. Abel,et al.  Symptoms versus flow rates versus urodynamics in the selection of patients for prostatectomy. , 1990, British journal of urology.

[5]  P. Doyle,et al.  Serial residual volumes in men with prostatic hypertrophy. , 1988, British journal of urology.

[6]  J. Oesterling,et al.  Prostate specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate. , 1991, The Journal of urology.

[7]  D. Hanley,et al.  Symptom status and quality of life following prostatectomy. , 1988, JAMA.

[8]  D. Neal,et al.  Relationship between voiding pressures, symptoms and urodynamic findings in 253 men undergoing prostatectomy. , 1987, British journal of urology.

[9]  P. Abrams,et al.  The natural history of untreated "prostatism". , 1981, British journal of urology.

[10]  Bruskewitz Rc,et al.  Clinical manifestations of benign prostatic hyperplasia and indications for therapeutic intervention. , 1990 .

[11]  R C Bruskewitz,et al.  Analysis of presenting symptoms in prostatism. , 1984, The Journal of urology.

[12]  J. Andersen,et al.  Prostatism. I. The correlation between symptoms, cystometric and urodynamic findings. , 1979, Scandinavian journal of urology and nephrology.

[13]  C. Roehrborn,et al.  Can transabdominal ultrasound estimation of postvoiding residual (PVR) replace catheterization? , 1989, Urology.

[14]  R A Deyo,et al.  Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation. , 1991, Controlled clinical trials.

[15]  J. Blaivas,et al.  Multichannel urodynamic studies in men with benign prostatic hyperplasia. Indications and interpretation. , 1990, The Urologic clinics of North America.

[16]  J. Golomb,et al.  Variability and circadian changes in home uroflowmetry in patients with benign prostatic hyperplasia compared to normal controls. , 1992, The Journal of urology.

[17]  M. Barry,et al.  The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. , 1992, The Journal of urology.

[18]  R. Bruskewitz,et al.  Critical evaluation of transurethral resection and incision of the prostate , 1990, The Prostate. Supplement.

[19]  K. Jensen,et al.  Transurethral prostatic resection in the treatment of prostatism with high urinary flow. , 1983, The Journal of urology.

[20]  H. Lepor,et al.  The efficacy of transurethral resection of the prostate in men with moderate symptoms of prostatism. , 1990, The Journal of urology.

[21]  R. Bruskewitz,et al.  The relevance of minimum urethral resistance in prostatism. , 1983, The Journal of urology.

[22]  R. Bruskewitz,et al.  Value of postvoid residual urine determination in evaluation of prostatism. , 1982, Urology.

[23]  M. Barry.  Medical outcomes research and benign prostatic hyperplasia , 1990, The Prostate. Supplement.

[24]  P. O'Brien,et al.  Statistical considerations for performing multiple tests in a single experiment. 1. Introduction. , 1988, Mayo Clinic proceedings.

[25]  M. Barry,et al.  Epidemiology and natural history of benign prostatic hyperplasia. , 1990, The Urologic clinics of North America.

[26]  C. Roehrborn,et al.  The Role of Transabdominal Ultrasound in the Prostatic Hypertrophy , 1986 .

[27]  M. Resnick,et al.  High resolution analysis of human prostatic fluid by two‐dimensional electrophoresis , 1982, The Prostate.

[28]  S. Sidney,et al.  Reoperation and Mortality After Surgical Treatment of Benign Prostatic Hypertrophy in a Large Prepaid Medical Care Program , 1992, Medical care.

[29]  H. Morgenstern,et al.  Epidemiologic Research: Principles and Quantitative Methods. , 1983 .

[30]  K McPherson,et al.  Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. , 1989, The New England journal of medicine.

[31]  K. Jensen.  Clinical evaluation of routine urodynamic investigations in prostatism , 1989 .

[32]  Holtgrewe Hl.  American Urological Association survey of transurethral prostatectomy and the impact of changing medicare reimbursement. , 1990 .

[33]  W. Garraway,et al.  High prevalence of benign prostatic hypertrophy in the community , 1991, The Lancet.

[34]  H. Brønnum-Hansen,et al.  Elevated Mortality Following Transurethral Resection of the Prostate for Benign Hypertrophy!: But Why? , 1990, Medical care.