Natural history of lower urinary tract symptoms: preliminary report from a community-based Indian study

To describe the results of an analysis of baseline data from subjects included in the community-screening programme for lower urinary tract symptoms (LUTS) in the Anand and Kheda district in the Gujarat state of India.

In all, 2406 men aged >40 years were screened in the community in 18 villages. All subjects were given an International Prostate Symptom Score (IPSS) to complete, had a detailed physical examination, uroflowmetry and urine analysis, and were assessed using transabdominal and transrectal ultrasonography. Spearman's correlation coefficient was used to assess the relationships between quality of life (QoL), age, IPSS, maximum flow rate (Q(max)) and prostate volume (PV); stepwise multiple regression was also used.

The mean (sd) age of the men was 62.1 (9.5) years. The PV (mean 21.6 mL, sd 10.63) increased linearly with age, while Q(max) (mean 14.6 mL/s, sd 8.4) decreased linearly. The mean (sd) IPSS was 12.2 (8.6) and did not correlate with age but correlated strongly with QoL (coefficient 0.72). Nocturia was the commonest symptom but correlated least with the IPSS and QoL (0.56 and 0.44). The correlations between Q(max), IPSS and PV were weak to moderate. The subjects had a 56% higher risk of developing moderate to severe symptoms if their PV was >25 mL.

These Indian men had smaller prostates with higher symptom scores than reported in the West. The IPSS was the strongest predictor of QoL. Overall, the correlation between Q(max), IPSS and PV was weak to moderate.