Prevalence of Prostatitis-Like Symptoms in a Community Based Cohort of Older Men:

Overlap of different urological symptom complexes in a racially and ethnically diverse, community-based population of men and women

OBJECTIVE

To define the prevalence and overlap of symptom patterns traditionally associated with benign prostatic hyperplasia, chronic prostatitis/chronic pelvic pain syndrome, interstitial cystitis/painful bladder syndrome, and incontinence among men and women in a racially and ethnically diverse, community-based population.

SUBJECTS AND METHODS

In all, 5506 men and women aged 30-79 years were recruited to participate in the Boston Area Community Health Survey, using a stratified-cluster sampling technique to obtain roughly similar representative samples by age group, gender and race/ethnicity (White, Black, Hispanic). Survey data were collected by bilingual interviewers in subjects' homes. Scales measuring symptom patterns were derived from validated instruments, with minor changes to eliminate different recall periods and overlap in items that might have confused subjects.

RESULTS

About a quarter of men and women of all ages met the definition for one or more of the target symptom patterns; there was no significant variation in the prevalence of any of the symptom patterns by race/ethnicity. Overall, approximately 16% of men and women had one symptom pattern, while 7% had overlap patterns. Except for urinary incontinence and interstitial cystitis/painful bladder syndrome in both men and women, the prevalence of all symptom complexes were associated with one another significantly more often that would be expected by chance.

CONCLUSIONS

Overlapping patterns of lower urinary tract symptoms and pelvic pain are common. These overlapping patterns present challenges for clinical practice and research, and require further investigation of their causes, diagnosis and optimum treatment.

The future magnitude of urological symptoms in the USA: projections using the Boston Area Community Health survey

OBJECTIVE

To use the population-based data from the Boston Area Community Health (BACH) Survey to estimate the likely magnitude (prevalence) of urological symptoms in the USA population in 2025, as health-services researchers use projections of the likely magnitude of disease to inform decisions on the future allocation of health resources.

METHODS

Age and gender-specific prevalence rates from BACH were combined with USA population projections to estimate the likely magnitude of lower urinary tract symptoms (LUTS) and symptoms suggestive of urine leakage, painful bladder syndrome (PBlS) and prostatitis (men only).

RESULTS

In total and accounting for overlapping symptoms, 52 million adults in the USA will have symptoms of LUTS, urine leakage, PBlS or prostatitis in 2025. These urological symptoms have a large impact on physical and mental aspects of quality of life, that is comparable to other chronic conditions.

CONCLUSIONS

The future magnitude of symptoms indicative of these four urological conditions might reach the current level of cardiovascular disease in the USA, which is considered 'a modern epidemic.' Our projections have important implications for medical education, training of healthcare providers, health-services research, and policy and patient education.

Epidemiologic risk factors for chronic prostatitis

Chronic prostatitis/chronic pelvic pain syndrome is a multifactorial problem, which affects men of all ages and in all demographics. Recent studies have shown that the prevalence of prostatitis is approximately 2-10% among unselected men in North America, Europe and Asia. This data clearly indicates that chronic prostatitis constitutes an important problem in international health care. Nevertheless, the aetiology and pathogenesis of chronic prostatitis have yet to be clearly delineated, despite the numerous efforts which have been made, with regard to both basic and clinical research. In fact, factors other than leucocytes and bacteria have been shown to contribute to the symptoms typically associated with prostatitis. Studies of the epidemiology and determinants of prostatitis risk factors may also provide clues to the general aetiology of prostatitis. Other epidemiological data appears to indicate that certain as-yet-unknown factors might be associated with an increased tendency towards the development of chronic prostatitis. However, findings from most studies are considered to represent only preliminary data, because of the small sample sizes or lack of generalizability inherent to most of the studies. The identification and characterization of these relevant risk factors might accelerate or augment the development of preventive, diagnostic, and therapeutic strategies for the treatment of these syndromes.