There is a strong epidemiological background to this section. In the first article, a Swedish group assess the prevalence of LUTS in a population-based study of 40 000 Swedish men aged 45–79 years. The second is a community-based study from India into the natural history of LUTS. Both papers contain some surprising results which are of interest to urologists, add to the general debate and to our knowledge of the symptoms associated with prostatic disease.
To estimate the age-specific prevalence and severity of lower urinary tract symptoms (LUTS) among Swedish men, the intercorrelations between different symptoms, and to assess quality of life and health-seeking behaviour among men with LUTS.
SUBJECTS AND METHODS
In 1997, an International Prostate Symptom Score (IPSS) questionnaire, together with other questions about lifestyle, was mailed to all men aged 45-79 years living in two counties in Sweden; the analyses included 39 928 men.
Overall, 18.5% and 4.8% of the men were moderately and severely symptomatic; the prevalence of at least one symptom was 83%. LUTS were strongly age-dependent, with 1.8% of severe symptoms among men aged 45–49 years and increasing to 9.7% among those 75–79 years old. Frequent urination was the most common symptom among men aged <70 years and nocturia among those aged >70 years. Symptoms like hesitancy, poor flow and intermittency were highly correlated with each other (Spearman coefficients 0.56–0.60). There was a high correlation between the IPSS and a poor score for quality of life resulting from the bothersomeness of LUTS (r = 0.70). Among symptomatic subjects, 36% reported a poor quality of life (fairly bad, very bad or terrible). Only 29% of symptomatic subjects (IPSS >7) reported that they had been diagnosed previously for their urinary problems, and only 11% received medication for that.
Although the prevalence of LUTS in Sweden is high, the percentage of men whose quality of life is substantially affected is much lower.