Association of health-related quality of life and benign prostatic enlargement

Objective: To investigate the association of benign prostatic enlargement and health-related quality of life (HRQoL) assessed by validated questionnaires. Method: Randomly selected men (n = 471) aged 40-79 years from Olmsted County, Minn. (USA) without prior prostate surgery or prostate cancer had a full urologic workup, including transrectal ultrasonography, in addition to completing questionnaires soliciting information about urinary symptom frequency, bother, degree of interference with daily activities and other measures of HRQoL. Results: Disease-specific HRQoL was worse in older men, and men with more severe symptoms. Age-adjusted mean scores for symptom severity, bother and activity interference were about 50% worse for men with enlarged prostates (volume > 40 cm³). After adjusting for age, men with enlarged prostates were nearly 3 times (95% CI 1.6, 5.1) as likely to have moderate to severe symptoms, and about twice as likely to have bother (odds ratio 2.4; 95% CI 1.3, 4.2) or activity interference (odds ratio 1.8; 95% CI 1.0, 3.2) relative to men with smaller prostates. Conclusion: HRQoL measures are worse in men who are older and, after adjusting for age, in men with increased urinary symptom frequency and enlarged prostate. The broader spectrum of patients provided by the community-based random sampling allows elucidation of these important relationships.