In a recent scientific article published by Merdy D, Eckhardt and other researchers from the Department of Urology, University Medical Center, Utrecht, The Netherlands to investigate the associations of symptoms and quality of life with age, prostate volume, and act of urine voiding parameters in a large group of strictly selected men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia or BPH. BPH occurs very commonly in elderly men.
The objective of this study is to find out the symptoms and quality of life with age, prostate size and urodynamic effects in a group of 565 men with enlarged non cancerous prostate.
Around 565 patients suffering from Lower urinary tract symptoms or LUTS, were referred from a hospital after doing preliminary screening. Men above 50 years, capable of excreting more than 150 ml of urine and measurable prostate size, were selected. All the men were screened and were expected to excrete more than 150 ml urine, measured by uroflowmetry (a machine used to measure the rate of urine flow). The left over urine and prostate sizes were also measured. The degree of urine flow obstruction was also measured and so was the ability of the bladder to contract.
The study showed that 301 men had obstruction, while 264 didn't have any. Also out of total subjects, 31 had a prostate size of less than 20 ml, while out of 565, 259 had an uncontrollable bladder. This study showed a negative correlation between age, symptoms and quality of life. Also, it was noticed that quality of life was not affected by leftover urine in the bladder. Although the prostate size did not affect symptoms, but ability of bladder to contract (contract actability) and low bladder volume did affect the symptoms of the patients, Leftover urine in the bladder did not affect quality of life.
Except for night urination, older men reported a low rate of urine excretion. Also, low bladder contractability and low volume of the bladder did not affect the symptoms of the patients. However, these did not affect the quality of life of patients.
The World Health Organisation adapted International Prostate Symptom Score (IPSS) and Quality of Life question, are the two important parameters to evaluate men with Lower Urinary Tract Symptoms (LUTS). The IPSS, contained seven questions like: - Incomplete emptying of urine bladder, frequency of urination, intermittent, urgency of passing urine, weak urinary stream, hesitant to pass urine or not, and excess urination at night. One question related to Quality of life of the patients.
The amount of urinary flow obstruction is measured by the urodynamic examination, which includes urinary bladder and urethral behaviour in men with LUTS. Size of prostate gland and uroflowmetry are both important in diagnosis of LUTS due to increased prostate.
According to various studies, symptoms are not directly related to prostate size, urinary flow rate, left over urine or degree of urinary flow obstruction. However, incomplete bladder contraction or reduced bladder capacity may affect LUTS. Hence the purpose of this study was to see whether the symptoms of the patients affected the quality of life, prostate size amount of obstruction of urine flow, residual urine and irregular bladder contraction, etc. Older men had more frequency of urination at night, but did not have much weak urine flow, hesitancy, and incomplete emptying of bladder was concerned. Also, the prostate size did not affect the symptoms or quality of life.
Compiled from various international research journals available at google scholar by D. Mukherjee having 38 years of pharmaceutical (Cardiac, Diabetic, Neurology, Pain & Inflammation products) experience with a Swiss Multinational Company NOVARTIS and edited by Dr Sandeep Ahlawat, MBBS