Perceived partner responsiveness between benign prostatic hyperplasia's symptom index and aging male symptoms

Benign prostatic hyperplasia (BPH) is common among aging men and often overlaps with aging male symptoms (AMS), which include somatic, psychological, and sexual complaints. These conditions can have serious consequences, potentially leading to falls, depression, and costly hospitalizations. Although attachment theory proposes that perceived partner responsiveness (PPR) can mitigate the negative effects of chronic health conditions, the precise relationship between the benign prostatic hyperplasia symptom index (BPHSI), PPR, and AMS has not been clearly established. This cross-sectional study recruited 412 men aged 50 or older with confirmed BPH. Participants completed questionnaires, including the Benign Prostatic Hyperplasia Symptom Index Scale, Aging Male Symptoms Scale, and Perceived Partner Responsiveness Scale. Structural equation modeling and bootstrapped mediation analyses were used to assess direct and indirect effects. BPHSI was significantly associated with AMS, indicating that greater BPH symptom severity was related to more severe aging-related symptoms. BPHSI was positively associated with perceived partner responsiveness among participants with severe symptoms but not among those with moderate symptoms. Mediation analyses showed that PPR did not mediate the relationship between moderate BPHSI and AMS. For severe BPHSI, a statistically significant but small indirect effect through PPR was observed, indicating partial mediation with limited explanatory contribution. Higher BPHSI severity was associated with higher AMS scores. Although perceived partner responsiveness demonstrated a limited mediating role among men with severe symptom burden, its contribution was modest compared with the direct effects of BPHSI. These findings suggest that effective management of urinary symptoms should remain the primary clinical priority, while psychosocial and partner-focused interventions may serve as complementary approaches for selected patients.