The Relation of Lower Urinary Tract Symptoms with Life-style Factors and Objective Measures of Benign Prostatic Enlargement and Obstruction: an Italian Survey

Objectives: The association between the severity of LUTS and prostate volume, prostate-related variables and general life-style factors was investigated in a large number of patients with persistent LUTS suggestive of BPH (LUTS/BPH).

Methods: Patients with LUTS/BPH aged between 50 and 80 years, were enrolled in this Italian, multicentre, observational study. The total, storage and voiding I-PSS and I-PSS-QoL index were collected, prostate volume and urodynamic variables measured. Multiple logistic regression equations were used to obtain the odds ratio (and 95% confidence interval) of moderate plus severe I-PSS (>7) versus mild I-PSS (< or =7, reference category), with allowance for age stratification, whenever indicated.

Results: In total, 802 patients were evaluated. The strongest association was found between the total I-PSS and the QoL. There was a slightly increased risk to suffer from more severe LUTS with increasing age. A significant increase risk of developing storage symptoms was found in older patient cohorts. Decrease of Q(max) values, increase of Abrams-Griffith number, serum PSA levels and prostate volume as judged by digital rectal examination were significantly associated to a higher risk of developing LUTS. No association was found between symptom severity and prostate volume or post-voiding residual, estimated by ultrasound.

Conclusions: No significant association between severity of LUTS and life-style factors was observed. An increased risk of developing LUTS was found in patients with lower maximum flow rate and in those with higher PSA values. The association between LUTS and prostate volume remains questionable.