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Natural History of Prostatism: Relationship Among Symptoms, Prostate Volume and Peak Urinary Flow Rate

1995; Lippincott Williams & Wilkins; Volume: 153; Issue: 5 Linguagem: Inglês

10.1016/s0022-5347(01)67448-2

1527-3792

Cynthia J. Girman, Steven J. Jacobsen, Harry A. Guess, Joseph E. Oesterling, Christopher G. Chute, Laurel A. Panser, Michael M. Lieber,

Pelvic floor disorders treatments

No AccessJournal of UrologyClinical Urology: Original Article1 May 1995Natural History of Prostatism: Relationship Among Symptoms, Prostate Volume and Peak Urinary Flow Rate Cynthia J. Girman, Steven J. Jacobsen, Harry A. Guess, Joseph E. Oesterling, Christopher G. Chute, Laurel A. Panser, and Michael M. Lieber Cynthia J. GirmanCynthia J. Girman , Steven J. JacobsenSteven J. Jacobsen , Harry A. GuessHarry A. Guess , Joseph E. OesterlingJoseph E. Oesterling , Christopher G. ChuteChristopher G. Chute , Laurel A. PanserLaurel A. Panser , and Michael M. LieberMichael M. Lieber View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67448-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail We describe relationships among symptoms, prostate volume and peak urinary flow rate in an age stratified, community based random sample of white men 40 to 79 years old with no prior prostate surgery, prostate cancer or other conditions known to interfere with voiding. Symptoms were assessed with an instrument comparable to the American Urological Association symptom index. Prostate volume was estimated by transrectal ultrasonography and peak urinary flow rate was measured by a portable device. Subject age was significantly associated with symptom score but accounted for only 3 percent of its variation, while prostate volume and peak urinary flow rate explained only an additional 10 percent of the symptom variability. The odds (95 percent confidence interval) of moderate to severe symptoms increased with age from 1.9 (1.1 to 3.1), 2.9 (1.7 to 5.0) and 3.4 (1.8 to 6.1) for men 50 to 59, 60 to 69 and 70 to 79 years old, respectively, relative to men 40 to 49 years old. Adjusting for age, the odds of moderate to severe symptoms were 3.5 times greater for men with prostatic enlargement (more than 50 ml.) than for men with smaller prostates, while the odds were similarly increased (2.4-fold) for men not achieving a peak urinary flow rate of 10 ml. per second. Estimated odds changed little when other cutoff points were considered for peak urinary flow rate (15 ml. per second) or prostate volume (40 ml.). These results, based on randomly selected white men, suggest a somewhat stronger, albeit modest, relationship among symptoms, prostate size and urinary flow rate than previously reported in clinic based studies. The strength of these relationships is comparable to that found with other diseases. References 1 : Benign Prostatic Hyperplasia: Diagnosis and Treatment. Clinical Practice Guideline, Number 8, AHCPR Publication No. 94-0582.. Rockville, Maryland: Agency for Health Care Policy and Research, Public Health Service, United States Department of Health and Human ServicesFebruary 1994. Google Scholar 2 : Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia.. J. Urol.1993; 150: 351. Abstract, Google Scholar 3 : Some clinical aspects of uroflowmetry in elderly males. A population survey.. Scand. J. Urol. Nephrol.1986; 20: 93. Google Scholar 4 : Significance of prostate weight in prostatism.. Urol. Int.1983; 38: 173. Google Scholar 5 : The significance of symptoms associated with bladder outflow obstruction.. Urol. Int.1978; 33: 171. Google Scholar 6 : Controversies about indications for transurethral resection of the prostate.. J. Urol.1989; 141: 475. Abstract, Google Scholar 7 : Clinical manifestations of benign prostatic hyperplasia and indications for therapeutic intervention.. Urol. Clin. N. Amer.1990; 17: 509. Google Scholar 8 : Urodynamics in benign prostatic hyperplasia: a survey.. Prostate1989; 2: 69. Google Scholar 9 : Prostatism. I. The correlation between symptoms, cystometric and urodynamic findings.. Scand. J. Urol. Nephrol.1979; 13: 229. Google Scholar 10 : The relevance of minimum urethral resistance in prostatism.. J. Urol.1983; 129: 769. Abstract, Google Scholar 11 : Clinical evaluation of routine urodynamic investigations in prostatism.. Neurourol. Urodynam.1983; 8: 545. Google Scholar 12 Guess, H. A., Jacobsen, S. J., Girman, C. J., Oesterling, J. E., Chute, C. G., Panser, L. A. and Lieber, M. M.: The role of community-based longitudinal studies in evaluating treatment effects--example: benign prostatic hyperplasia. Medical Care, in press. Google Scholar 13 : Problems of spectrum and bias in evaluating the efficacy of diagnostic tests.. New Engl. J. Med.1978; 299: 926. Google Scholar 14 : A population-based study of health care-seeking behavior for treatment of urinary symptoms. The Olmsted County study of urinary symptoms and health status among men.. Arch. Fam. Med.1993; 2: 729. Google Scholar 15 Ballard, D. J. and Duncan, P. W.: Role of population-based epidemiologic surveillance in clinical practice guideline development. Forum Method. Man. Guideline Development, in press. Google Scholar 16 : Referral selection bias in the Medicare hospital mortality prediction model: are centers of referral for Medicare beneficiaries necessarily centers of excellence?. Health Services Res.1994; 28: 771. Google Scholar 17 : Sample selection and the natural history of disease--studies of febrile seizures.. J.A.M.A.1980; 243: 1337. Google Scholar 18 : The prevalence of prostatism: a population-based survey of urinary symptoms.. J. Urol.1993; 150: 85. Abstract, Google Scholar 19 : Similar levels of urological symptoms have similar impact on Scottish and American men--although Scots report less symptoms.. J. Urol.1993; 150: 1701. part 2. Abstract, Google Scholar 20 : Population studies in Rochester and Olmsted County, Minnesota, 1900-1968. In: The Community as an Epidemiologic Laboratory. Edited by . Baltimore: The Johns Hopkins University Press1970: 47. chapt. 3. Google Scholar 21 : The patient record in epidemiology.. Sci. Amer.1981; 245: 54. Google Scholar 22 : Validation of a new quality of life questionnaire for benign prostatic hyperplasia.. J. Clin. Epidemiol.1992; 45: 1431. Google Scholar 23 : Natural history of prostatism: urinary flow rates in a community-based study.. J. Urol.1993; 150: 887. Abstract, Google Scholar 24 : Serum prostate specific antigen in a community-based population of healthy men: establishment of age-specific reference ranges.. J.A.M.A.1993; 270: 860. Google Scholar 25 : The American Urological Association symptom index for benign prostatic hyperplasia.. J. Urol.1992; 148: 1549. Abstract, Google Scholar 26 : Indications for treatment of benign prostatic hyperplasia. The American Urological Association study.. Cancer1992; 70: 280. Google Scholar 27 : The assessment of prostatic obstruction from urodynamic measurements and from residual urine.. Brit. J. Urol.1979; 51: 129. Google Scholar 28 : Statistical Methods in Epidemiology. New York: Oxford University Press1989. Google Scholar 29 : Cholesterol and coronary artery disease: age as an effect modifier.. J. Clin. Epidemiol.1992; 45: 1053. Google Scholar 30 : Measurement characteristics of three asthma symptom diaries validated in three separate studies of mild to moderate asthma patients.. Respir. Crit. Care Med.1994; 149: A917. Google Scholar 31 : Calcium intake and the relationship of dietary sodium and potassium to blood pressure.. Amer. J. Clin. Nutr.1988; 48: 1463. Google Scholar 32 : Linking clinical variables with health-related quality of life.. J.A.M.A.1995; 273: 59. Google Scholar 33 : Alternatives to surgery for benign prostatic hyperplasia.. Cancer1992; 70: 374. Google Scholar 34 : Benign prostatic hyperplasia: the scope of the problem.. Cancer1992; 70: 275. Google Scholar 35 : Analysis of presenting symptoms of prostatism.. J. Urol.1984; 132: 272. Abstract, Google Scholar 36 : Association between symptomatology and uroflowmetry in BPH.. Brit. J. Urol.1988; 62: 427. Google Scholar 37 : Variability and circadian changes in home uroflowmetry in patients with benign prostatic hyperplasia compared to normal controls.. J. Urol.1992; 147: 1044. Abstract, Google Scholar 38 Roehrborn, C., di Sylverio, F., Leriche, A., Rubben, H. and Watanabe, H.: Diagnostic work-up of patients presenting with symptoms suggestive of prostatism. In: International Consultation on Benign Prostatic Hyperplasia (BPH). Edited by A. T. K. Cockett, Y. Aso, C. Chatelain, L. Denis, K. Griffiths, S. Khoury and G. Murphy. Conference Proceedings, p. 93, 1991. Google Scholar 39 : A comparison of quality of life with patient reported symptoms and objective findings in men with benign prostatic hyperplasia.. J. Urol.1993; 150: 1696. part 2. Abstract, Google Scholar 40 : Objective and subjective response criteria to diagnose benign prostatic hyperplasia.. Eur. Urol.1993; 24: 2. Google Scholar 41 : Benign prostatic hyperplasia: antecedents and natural history.. Epid. Rev.1992; 14: 131. Google Scholar 42 Collins, G. N., Raab, G. M., Hehir, M., King, B. and Garraway, W. M.: Observer variability and reproducibility of transrectal ultrasound in the measurement of prostatic volume. Ultrasound Med. Biol., in press. Google Scholar 43 : Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal examination and prostate specific antigen.. J. Urol.1990; 143: 1146. Abstract, Google Scholar 44 : Using repeated measures of symptom score, uroflow and prostate specific antigen in the clinical management of prostate disease.. J. Urol.1995; 153: 99. Abstract, Google Scholar 45 : Comparison of AUA symptom index in unselected males and females between fifty-five and seventy-nine years of age.. Urology1993; 42: 36. Google Scholar 46 : American Urological Association symptom index for women with voiding symptoms: lack of index specificity for benign prostate hyperplasia.. J. Urol.1993; 150: 1706. part 2. Abstract, Google Scholar 47 : Specificity of the American Urological Association voiding symptom index: comparison of unselected and selected samples of both sexes.. J. Urol.1993; 150: 1710. part 2. Abstract, Google Scholar 48 Guess, H. A.: The prevalence of BPH in population surveys. In: Proceedings of the International Symposium on the Epidemiology of Prostate Disease, in press. Google Scholar 49 : Importance of the natural history of benign prostatic hyperplasia in the evaluation of pharmacologic intervention.. Prostate1990; 3: 1. Google Scholar 50 : Benign prostatic hyperplasia and its treatment.. J. Gen. Intern. Med.1990; 5: 153. Google Scholar 51 : Effect of several recruitment strategies on response rates at baseline in a prospective cohort investigation: the Olmsted County study of urinary symptoms and health status among men.. Ann. Epidemiol.1994; 4: 321. Google Scholar 52 : The natural history of prostatism: the effects of non-response bias.. Int. J. Epidemiol.1994; 23: 1198. Google Scholar From the Department of Epidemiology, Merck Research Laboratories, West Point, Pennsylvania, Section of Clinical Epidemiology, Health Sciences Research and Department of Urology, Mayo Clinic, Rochester, Minnesota, Departments of Epidemiology and Biostatics, University of North Carolina, Chapel Hill, North Carolina, and Section of Urology, University of Michigan and The Michigan Prostate Institute, Ann Arbor, Michigan.© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byZhou S, Chang E, Patankar A, Huang J, Marks L and Natarajan S (2019) Prostate Cancer Detection Rate of Freehand versus 3-Dimensional Template Mapping Biopsy Using a Magnetic Resonance Imaging-Ultrasound Fusion Device in Biopsy Naïve MenJournal of Urology, VOL. 203, NO. 4, (699-705), Online publication date: 1-Apr-2020.Simon R, Howard L, Moreira D, Roehrborn C, Vidal A, Castro-Santamaria R and Freedland S (2017) Does Peak Urine Flow Rate Predict the Development of Incident Lower Urinary Tract Symptoms in Men with Mild to No Current Symptoms? 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Volume 153Issue 5May 1995Page: 1510-1515 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Cynthia J. Girman More articles by this author Steven J. Jacobsen More articles by this author Harry A. Guess More articles by this author Joseph E. Oesterling More articles by this author Christopher G. Chute More articles by this author Laurel A. Panser More articles by this author Michael M. Lieber More articles by this author Expand All Advertisement PDF downloadLoading ...