[Benign prostatic hyperplasia--dos the frequency of operations depend on insurance status?]

In this epidemiologic study, conducted in a representative age-stratified cohort of the town of Zurich, 1221 men aged 65, 70, 75, 80 and 85 years (accidentally at least 200 men in each of the five age groups) returned the correctly completed questionnaire containing standardized questions on those symptoms, which can be caused by BPH, also on digital rectal examination of the prostate gland, done by urologist or family doctor, and therefore, if the BPH has been diagnosed and, for that reason, if surgical or nonsurgical treatment. Calculating the age-specific prevalence of BPH and the prostate symptom score (international PSS), this study evaluates the relation between prostatectomy (results of surgery) and the health-insurance status. The logistic regression as multivariate analysis, the effects of age and professional education adjusted in the first step, reveals that the insurance status does not reflect the indication for surgery. The means of PSS are very low in men, BPH being never diagnosed, moderate in men with prostatectomy and higher in men with diagnosed BPH but without need for surgery, highest in men with subjective and objective indication for surgical intervention: the means of PSS by insurance status are in each of these four groups homogeneous. On the other hand, persons with only basic health-insurance seem much more to omit the digital examination of the prostate gland. Nevertheless, the complaints or symptoms caused by BPH, as stated by the patients in a quantitative manner of increasing severity, take care that the patient himself, not waiting too long, decides to visit a doctor. The quality of life, examined by classes of PSS, depends clearly from the persisting symptoms; the insurance status cannot show statistically any evident influence.