Trueman P, Hood S C, Nayak U S, Mrazek M F
Global Health Outcomes, Glaxo Wellcome R & D, Greenford, Middlesex, UK.
BJU Int. 1999 Mar;83(4):410-5. doi: 10.1046/j.1464-410x.1999.00966.x.
To assess the prevalence of lower urinary tract symptoms (LUTS) in a community-based population in the UK, to measure the impact of these symptoms on quality of life and health status in men with self-reported 'benign prostatic hyperplasia' ('BPH'), and to evaluate health-seeking behaviour in this population.
A postal survey was distributed to an age-stratified random sample of 1500 men aged 50 years or older from throughout England, Scotland and Wales. The self-administered survey included: demographic questions; the EuroQoL (EQ-5D) instrument, consisting of a health-status index questionnaire and a visual analogue scale (VAS) on which participants rated their current health status; the International Prostate Symptom Score (IPSS) questionnaire; and a questionnaire assessing the participants' health-seeking behaviour and awareness of BPH.
Responses to the survey were received from 1115 (74%) of the 1500 men. Overall, 41% (450/ 088) had an IPSS of > or =8, indicating moderate-to-severe LUTS, yet only 196 men (18%) reported that they had been diagnosed with 'BPH'. Both quality of life (as measured by the EQ-5D) and general health status (as measured by the VAS) decreased as urinary symptom severity increased, and the greater the severity, the more men who reported a problem with mobility, self-care, usual activity, pain/discomfort, and anxiety/depression (the five domains of the EQ-5D). The possibility of symptoms worsening appeared to be the key determinant in the respondents' decisions to consult a medical professional for their LUTS. Less than 11% of the respondents were aware of the availability of specific prescription drug therapies or surgical options for the treatment of 'BPH'. The most common first treatment strategy for those consulting for symptoms was watchful waiting (34%), followed by surgery (30%) and prescription drugs (21%).
Moderate-to-severe LUTS were relatively common in this UK population of men over the age of 50, yet relatively few had been diagnosed with 'BPH'. As LUTS adversely affect quality of life, improved treatment options and increased public awareness of BPH and LUTS are needed to combat a problem facing the growing number of elderly men in the population.
评估英国社区人群下尿路症状（LUTS）的患病率，衡量这些症状对自我报告患有“良性前列腺增生”（“BPH”）的男性生活质量和健康状况的影响，并评估该人群的就医行为。
向来自英格兰、苏格兰和威尔士的1500名50岁及以上的男性进行年龄分层随机抽样，通过邮寄方式发放调查问卷。自行填写的调查问卷包括：人口统计学问题；欧洲生活质量量表（EQ-5D），由健康状况指数问卷和视觉模拟量表（VAS）组成，参与者可在该量表上对自己当前的健康状况进行评分；国际前列腺症状评分（IPSS）问卷；以及一份评估参与者就医行为和对BPH认知情况的问卷。
1500名男性中有1115人（74%）回复了调查问卷。总体而言，41%（450/1088）的男性IPSS评分≥8，表明存在中度至重度LUTS，但只有196名男性（18%）报告他们被诊断患有“BPH”。随着尿路症状严重程度的增加，生活质量（通过EQ-5D衡量）和总体健康状况（通过VAS衡量）均下降，症状越严重，报告在行动能力、自我护理、日常活动、疼痛/不适以及焦虑/抑郁（EQ-5D的五个领域）方面存在问题的男性就越多。症状恶化的可能性似乎是受访者就其LUTS咨询医疗专业人员决策的关键决定因素。不到11%的受访者知道有专门用于治疗“BPH”的处方药疗法或手术选择。因症状咨询的人群中最常见的初始治疗策略是观察等待（34%），其次是手术（30%）和处方药（21%）。
在英国这群50岁以上的男性人群中，中度至重度LUTS相对常见，但被诊断患有“BPH”的人相对较少。由于LUTS对生活质量有不利影响，需要改善治疗选择并提高公众对BPH和LUTS的认识，以应对该人群中越来越多老年男性面临的问题。
