Risk factors for lower urinary tract symptoms in elderly men. For the Prostate Study Group of the Austrian Society of Urology.

OBJECTIVE

The aim of this study was to confirm previous studies with respect to risk factors for lower urinary tract symptoms (LUTS) as assessed by the International Prostate Symptom Score (IPSS) as well as, for the first time, specifically for storage and voiding symptoms in elderly men.

MATERIAL AND METHODS

During a health survey organised in the area of Vienna in 1996, the following parameters were obtained: (1) IPSS including the quality of life question; (2) a detailed medical history; (3) assessment of all concurrent medical therapies; (4) physical examination with assessment of age, weight, height, body mass index, heart rate and blood pressure; (5) sociodemographic parameters, and (6) a blood laboratory study including kidney and liver function tests, low- and high-density lipoproteins, cholesterol and glucose. Only men aged 40 years or older without previous surgery to the prostate and without concurrent medication for LUTS were analysed. The IPSS, its irritative (storage symptoms) and obstructive (voiding symptoms) components were correlated to these parameters by partial correlation analysis which was controlled for age.

RESULTS

The data of 1,557 men (mean age: 51.3 years; range: 40-96 years) were analysed. The most important risk factor for the development of LUTS was age, as the IPSS (correlation coefficient r = 0.294), its obstructive (r = 0.248) and irritative (r = 0.261) components all correlated significantly (p<0.0001) with patient age. In all life decades there was no significant difference of the IPSS, its obstructive and irritative components in current smokers and non-smokers. The irritative score, however, correlated significantly (p = 0.001; r = 0.158) with the number of cigarettes smoked per day. In men aged 40-49 years, regular alcohol consumption resulted in a higher total IPSS (p = 0.01) and irritative (p = 0.002) score. This difference was not demonstrable in older age groups. Patient weight and body mass index did not correlate with the IPSS, yet there was a trend for a higher IPSS in men with elevated blood pressure and larger waist size.

CONCLUSIONS

This large-scale cross-sectional study underlines the importance of age for the development of LUTS. Few avoidable risk factors for the development of LUTS have been identified, such as obesity, cigarette smoking, elevated blood pressure and alcohol consumption. The subcategorization of LUTS into irritative/obstructive symptoms might provide new insights into the assessment of risk factors for LUTS.