📃 Paper Title: Treatment for benign prostatic hyperplasia among community dwelling men: the Olmstead County study of urinary symptoms and health status
🧍 Author: Steven J. Jacobsen
🕒 Year: 1999
📚 Journal: The Journal of Urology
🌎 Country: USA
ㅤContext to the study:
In the Olmsted County study, what factors were associated with men requiring treatment for BPH?
ㅤ✅ Take-home message of study:
Nearly 1 in 4 men will receive BPH treatment (medical or surgical) in their 80s. Men with moderate-to-severe LUTS, reduced flow, or larger prostates are more likely to undergo treatment and these were also associated with other adverse outcomes including acute urinary retention.
ㅤ Prospective cohort study
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Study participants:
Inclusion:
Stratified random sample of men aged 40 to 79 as of 01/01/1990 from the Rochester Epidemiology Project
Exclusion:
Prostate cancer, prostatectomy, other medical conditions that affect voiding
2115 participants included, with median 50 months follow-up.
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Key study outcomes:
The primary outcome was treatment for BPH, either medical or surgical. 167 received treatment (pharmacological: 113, TURP: 45, 'minimally invasive surgical procedure': 19). For all treatments there was a strong age related increase in risk of treatment. Men with moderate-to-severe symptoms, reduced flow rates, enlarged prostate, or elevated serum PSA were 4-5 times more likely to need BPH treatment.
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Study Limitations:
Men were routinely contacted, and some men had very intense follow-up, which may have influenced patient and physician behaviours and decisions through the Hawthorne effect. There is likely some selection bias in how men were chosen to take part (responding to a survey); men with more severe disease who had already been treated would very likely have been excluded. Men with medical conditions that might affect normal voiding were excluded, for example neurological disease. The population is from Olmsted County and therefore may not be representative of all US populations.
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