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Natural history of lower urinary tract symptoms in Japanese men from a 15-year longitudinal community-based study

By F.Fukuta, N. Masumori, M. Mori and T. Tsukamoto

BJU International, Volume 110, Issue 7, October 2012, Pages 1023-1029

Study Type – Symptom prevalence (cohort)

Level of Evidence 2b

What's known on the subject? and What does the study add?
There have been few longitudinal community-based studies on LUTS suggestive of BPH. It is important to determine the natural history of LUTS suggestive of BPH among men in various countries because it is known that there are differences according to race. Although we previously reported a cross-sectional community-based survey on LUTS suggestive of BPH in Japanese men, no longitudinal data were available.

The present study provides 15-year longitudinal data on LUTS suggestive of BPH and related variables in Japanese men.

•To report the natural history of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) in Japanese men.

• From 1992 to 1993, we conducted a cross-sectional community-based study on LUTS suggestive of BPH in Japanese men aged 40–79 years.
• After 15 fifteen years, a follow-up study was conducted to determine their longitudinal changes of LUTS.
• Of the 319 participants taking part in the initial study, 135 participated again in the follow-up study.
• We investigated International Prostate Symptom Score (IPSS), quality of life index and bother score using a questionnaire, and measured prostate volume (PV), prostate-specific antigen (PSA) level and peak urinary flow rate (Qmax) using a method that we have employed previously.

• The change in the total IPSS during 15 years was significant (P= 0.001) and its mean (sd) annual change was 0.11 (0.40).
• Although there was little change in the bother score, a significant correlation was observed between changes in the IPSS and bother score (r= 0.528, P < 0.001).
• For the individual IPSS and bother scores, only changes in urgency, weak stream and nocturia were significant.
• The changes in PV, PSA level and Qmax were significant.
• The change in the total IPSS did not correlate with the changes in these variables.

• In a 15-year-longitudinal community-based study for Japanese men, we have shown that the IPSS and quality of life index deteriorated, PV and PSA level increased, and Qmax decreased.