Incidence and Progression of Lower Urinary Tract Symptoms in a Large Prospective Cohort of United States Men

No AccessJournal of UrologyAdult Urology1 Aug 2012Incidence and Progression of Lower Urinary Tract Symptoms in a Large Prospective Cohort of United States Men Elizabeth A. Platz, Corinne E. Joshu, Alison M. Mondul, Sarah B. Peskoe, Walter C. Willett, and Edward Giovannucci Elizabeth A. PlatzElizabeth A. Platz Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, the Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author , Corinne E. JoshuCorinne E. Joshu Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, the Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author , Alison M. MondulAlison M. Mondul Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, the Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author , Sarah B. PeskoeSarah B. Peskoe Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, the Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author , Walter C. WillettWalter C. Willett Departments of Nutrition and Epidemiology, Harvard School of Public Health, and the Channing Laboratory, Department of Medicine, Harvard Medical School, and Brigham & Women's Hospital, Boston, Massachusetts More articles by this author , and Edward GiovannucciEdward Giovannucci Departments of Nutrition and Epidemiology, Harvard School of Public Health, and the Channing Laboratory, Department of Medicine, Harvard Medical School, and Brigham & Women's Hospital, Boston, Massachusetts More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.03.125AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To support trials testing lifestyle interventions for lower urinary tract symptoms, often a consequence of benign prostatic hyperplasia, we estimated the incidence and progression rates of lower urinary tract symptoms in United States men unselected for benign prostatic hyperplasia. Materials and Methods: We studied men in the HPFS (Health Professionals Follow-Up Study) whom we asked to report periodically by mailed survey whether they had undergone surgery or used medications for lower urinary tract symptoms and to complete the International Prostate Symptom Score survey. For incidence we included 25,879 men with an International Prostate Symptom Score of 0 to 7 and no surgery history who were followed from 1992 to 2008. Incident moderate or worse lower urinary tract symptoms (6,058) were defined as an International Prostate Symptom Score of 15 or greater, surgery, or medication use. Modest or worse lower urinary tract symptoms were similarly defined but with an International Prostate Symptom Score of 8 or greater (11,352). For progression we included 9,628 men with an International Prostate Symptom Score of 8 to 14 and no surgery who were followed from when they first reported an International Prostate Symptom Score of 8 to 14 until 2008. Progression to severe lower urinary tract symptoms (2,557) was defined as an International Prostate Symptom Score of 20 or greater, surgery, or medication use. We estimated age specific and age standardized rates. Results: Incidence and progression rates increased with age (p trend <0.0001), and progression rates were higher than incidence rates. The age standardized rates were incidence of moderate to worse lower urinary tract symptoms 18.5, incidence of modest or worse lower urinary tract symptoms 40.5 and progression to severe lower urinary tract symptoms 44.9 per 1,000 man-years. Conclusions: The incidence and progression rates of lower urinary tract symptoms are high and increase steeply as men age. These rates may be used for planning adequately powered trials to test lifestyle interventions for lower urinary tract symptoms well before surgical or pharmacological treatment is indicated. References 1 : NIDDK Prostate Research Strategic Plan. 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Google Scholar © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byÅkerla J, Pesonen J, Pöyhönen A, Koskimäki J, Häkkinen J, Huhtala H, Auvinen A and Tammela T (2022) Lower Urinary Tract Symptoms and Mortality among Finnish Men: The Roles of Symptom Severity and BotherJournal of Urology, VOL. 207, NO. 6, (1285-1294), Online publication date: 1-Jun-2022.Roehrborn C, Gratzke C, McVary K, Gittelman M and Lowe F (2016) Are Over-the-Counter Alpha Blockers in the Best Interest of Men with Lower Urinary Tract Symptoms?Urology Practice, VOL. 4, NO. 5, (395-404), Online publication date: 1-Sep-2017.Zhang R, Sutcliffe S, Giovannucci E, Willett W, Platz E, Rosner B, Dimitrakoff J and Wu K (2015) Lifestyle and Risk of Chronic Prostatitis/Chronic Pelvic Pain Syndrome in a Cohort of United States Male Health ProfessionalsJournal of Urology, VOL. 194, NO. 5, (1295-1300), Online publication date: 1-Nov-2015.Mondul A, Giovannucci E and Platz E (2013) A Prospective Study of Obesity, and the Incidence and Progression of Lower Urinary Tract SymptomsJournal of Urology, VOL. 191, NO. 3, (715-721), Online publication date: 1-Mar-2014.Maserejian N, Chen S, Chiu G, Araujo A, Kupelian V, Hall S and McKinlay J (2013) Treatment Status and Progression or Regression of Lower Urinary Tract Symptoms in a General Adult Population SampleJournal of Urology, VOL. 191, NO. 1, (107-113), Online publication date: 1-Jan-2014.Martin S, Lange K, Haren M, Taylor A and Wittert G (2013) Risk Factors for Progression or Improvement of Lower Urinary Tract Symptoms in a Prospective Cohort of MenJournal of Urology, VOL. 191, NO. 1, (130-137), Online publication date: 1-Jan-2014. Volume 188Issue 2August 2012Page: 496-501 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordslower urinary tract symptomsmenincidencedisease progressionAcknowledgmentsThe research staff of the Health Professionals Follow-Up Study provided continued assistance in this study.MetricsAuthor Information Elizabeth A. Platz Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, the Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Corinne E. Joshu Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, the Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Alison M. Mondul Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, the Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Sarah B. Peskoe Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, the Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland More articles by this author Walter C. Willett Departments of Nutrition and Epidemiology, Harvard School of Public Health, and the Channing Laboratory, Department of Medicine, Harvard Medical School, and Brigham & Women's Hospital, Boston, Massachusetts More articles by this author Edward Giovannucci Departments of Nutrition and Epidemiology, Harvard School of Public Health, and the Channing Laboratory, Department of Medicine, Harvard Medical School, and Brigham & Women's Hospital, Boston, Massachusetts More articles by this author Expand All Advertisement PDF downloadLoading ...