A Comparison of Quality of Life with Patient Reported Symptoms and Objective Findings in Men with Benign Prostatic Hyperplasia

Abstract

As part of a randomized, controlled, trial conducted by the Department of Veterans Affairs Cooperative Studies Program comparing the effectiveness of transurethral resection of the prostate to watchful waiting, we evaluated 707 men with mild to severe symptoms of benign prostatic hyperplasia (BPH). We examine the relationships among patient reported symptoms, quality of life responses, peak urine flow rates and post-void residual urine estimates. Correlations among responses to symptom and quality of life interviews, urine flow results and residual urine volume were low (less than 0.20). However, multivariate correlation analysis showed that patient reported irritative symptoms, such as urgency, frequency and nocturia, were associated with quality of life responses, while patient reported obstructive symptoms, peak urinary flow rates and post-void urine estimates were unrelated to diminished quality of life. Since the extent to which BPH interferes with the life-style is likely to influence the decision of the patient to seek medical evaluation, the lack of association between quality of life and obstructive symptoms may result in misdirected diagnostic evaluations. This may have a large role in the controversies regarding assessments of symptomatic BPH, guidelines for surgical intervention and outcomes of treatment. Further study is required to determine the influence of diminished quality of life and irritative symptoms on the outcomes of treatments for BPH.