[Impact of prostatic symptoms in patients with prostatic benign hyperplasia]

To analyze the impact of prostatic symptoms and to identify the factors associated with the problems caused by these symptoms.

A descriptive, transverse study was conducted on 133 patients. The problems arising from prostatism were analyzed by means of a self-administered questionnaire, using the Symptomatic Prostatic Index (SPI), which was compared with the International Prostate Symptom Score (I-PSS), uroflowmetry, morbidity, medication required and sociodemographic variables. The reliability and consistency of the SPI scale were analyzed and the variables associated with a greater impact of prostatism were determined by linear regression analysis.

Patient mean age was 68.8 years. Mean scores were 20.1 and 4.75 for the I-PSS and IQL item, respectively. Mean and maximum urinary flow were below the 50th percentile in 95.2%. A high correlation was found between the items of the SPI questionnaire and between the items and the total score. The SPI scale showed a high discriminating power (delta = 0.95) and internal consistency (alpha = 0.82), and factorial analysis showed only one factor accounted for the 49.05% total variance. The SPI questionnaire score was 15.5 and involved the irritative symptoms, basically nocturia, proportionally more than the obstructive symptoms (p < 0.0001). A direct correlation was found between the higher SPI score and the severity of the prostatic symptoms (p < 0.0001) and, consequently, a worse quality of life (p < 0.0001). Younger patients tolerated the symptoms poorly (p = 0.002). Linear regression analysis confirmed that tolerance was worse in the younger patients with more severe symptoms and no other disease (r2 = 0.43, p < 0.0001).

The impact of prostatism increases according to its severity, particularly for the irritative symptoms, basically nocturia. Psychological factors may probably affect the variability of patient tolerance, indicating that the decision for treatment of BPH might be based on the problems it may cause and the impact on the quality of life more than on the severity of the symptoms.