World J Mens Health.  2012 Aug;30(2):131-137.

Prevalence of Benign Prostatic Hyperplasia on Jeju Island: Analysis from a Cross-sectional Community-based Survey

• Huh JS
• Kim YJ
• Kim SD

Abstract

PURPOSE
We report on the prevalence of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) among men of Jeju Island, representing a coastal and insular area, using a cross-sectional community-based survey.
MATERIALS AND METHODS
A total of 553 participants in a prostate health screening campaign on Jeju Island were subjected to measurements of the International Prostate Symptom Score (IPSS), prostate volume, uroflowmetry, postvoiding residual urine volume, and prostate-specific antigen levels. Eliminating 58 participants who were suspected of having prostate cancer, we analyzed the data from 495 participants. The definition of BPH was a combination of moderate IPSS (8~19) to severe IPSS (>19) and prostate enlargement (>30 g on transrectal ultrasonography).
RESULTS
The prevalence of BPH was 21.0% overall: 11.6% among subjects aged 50~59 years, 18.1% for those aged 60~69, 30.8% for those aged 70~79 and 50.8% among those aged 80 years or more. Compared with previous studies in urban or rural areas, the prevalence was slightly lower. The prevalence of BPH and of moderate to severe LUTS increased with age and showed significant differences between age groups (p=0.028 and 0.033, respectively). A positive correlation was found between the IPSS and quality of life score. Among subunits of IPSS, the nocturia score contributed most to the severity of LUTS and had the highest correlation with a quality of life score.
CONCLUSIONS
The overall prevalence of BPH in this study was 21.0%, which is slightly lower than in previous studies in urban or rural areas.

Keyword

Prostatic hyperplasia; Prevalence

MeSH Terms

Aged
Humans
Lower Urinary Tract Symptoms
Male
Mass Screening
Nocturia
Prevalence
Prostate
Prostate-Specific Antigen
Prostatic Hyperplasia
Prostatic Neoplasms
Quality of Life
Prostate-Specific Antigen

Figure

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  Fig. 1 Prevalence and severity of lower urinary tract symptoms (LUTS) in different age groups studied. The prevalence of moderate to severe LUTS increased significantly with age.

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  Fig. 2 Severity of subunits of lower urinary tract symptom (LUTS) categories in International Prostate Symptom Score (IPSS) questionnaire. The score for nocturia was highest followed by frequency.

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  Fig. 3 Pearson correlation coefficients of the IPSS with each parameter. Age* and Qmax* were weak correlation factors but the rest were strong correlation factors (p<0.001). IPSS: International Prostate Symptom Score, Qmax: peak urinary flow rate, QoL: quality of life.

Reference

1. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984. 132:474–479.

2. Lee E, Yoo KY, Kim Y, Shin Y, Lee C. Prevalence of lower urinary tract symptoms in Korean men in a community-based study. Eur Urol. 1998. 33:17–21.

3. Chung TG, Chung J, Lee MS, Ahn H. Prevalence of benign prostatic hyperplasia in Jeong-Eup area: community-based study. Korean J Urol. 1999. 40:52–58.

4. Rhew HY, Koo JH, Cho SS, Kang JS, Lee CK, Kim JC, et al. The prevalence of BPH in Busan city over age 40. Korean J Urol. 2001. 42:223–227.

5. Lee HL, Seo JW, Kim WJ. The prevalence of benign prostatic hyperplasia: community-based study in Chungbuk province. Korean J Urol. 1999. 40:1500–1505.

6. Park HK, Park H, Cho SY, Bae J, Jeong SJ, Hong SK, et al. The prevalence of benign prostatic hyperplasia in elderly men in Korea: a community-based study. Korean J Urol. 2009. 50:843–847.

7. Lee ES, Lee C, Kim Y, Shin Y. Estimation of benign prostatic hyperplasia prevalence in Korea: an epidemiological survey using international prostatic symptom score(IPSS) in Yonchon county. Korean J Urol. 1995. 36:1345–1352.

8. Barry MJ, Fowler FJ Jr, O'Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The Measurement Committee of the American Urological Association. The American Urological Association symptom index for benign prostatic hyperplasia. J Urol. 1992. 148:1549–1557.

9. Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet. 1991. 338:469–471.

10. Bosch JL, Kranse R, van Mastrigt R, Schröder FH. Reasons for the weak correlation between prostate volume and urethral resistance parameters in patients with prostatism. J Urol. 1995. 153:689–693.

11. Blanker MH, Groeneveld FP, Prins A, Bernsen RM, Bohnen AM, Bosch JL. Strong effects of definition and nonresponse bias on prevalence rates of clinical benign prostatic hyperplasia: the Krimpen study of male urogenital tract problems and general health status. BJU Int. 2000. 85:665–671.

12. Ukimura O, Kojima M, Inui E, Ochiai A, Hata Y, Watanabe M, et al. A statistical study of the American Urological Association symptom index for benign prostatic hyperplasia in participants of mass screening program for prostatic diseases using transrectal sonography. J Urol. 1996. 156:1673–1678.

13. Bosch JL, Hop WC, Kirkels WJ, Schröder FH. The International Prostate Symptom Score in a community-based sample of men between 55 and 74 years of age: prevalence and correlation of symptoms with age, prostate volume, flow rate and residual urine volume. Br J Urol. 1995. 75:622–630.

14. Norman RW, Nickel JC, Fish D, Pickett SN. 'Prostate-related symptoms' in Canadian men 50 years of age or older: prevalence and relationships among symptoms. Br J Urol. 1994. 74:542–550.

15. Chute CG, Panser LA, Girman CJ, Oesterling JE, Guess HA, Jacobsen SJ, et al. The prevalence of prostatism: a population-based survey of urinary symptoms. J Urol. 1993. 150:85–89.

16. Tsukamoto T, Kumamoto Y, Masumori N, Miyake H, Rhodes T, Girman CJ, et al. Prevalence of prostatism in Japanese men in a community-based study with comparison to a similar American study. J Urol. 1995. 154:391–395.

17. Andersson SO, Rashidkhani B, Karlberg L, Wolk A, Johansson JE. Prevalence of lower urinary tract symptoms in men aged 45-79 years: a population-based study of 40 000 Swedish men. BJU Int. 2004. 94:327–331.

18. Rha KH, Choi YD, Hong SJ, Song JS, Kim BH, Choi HS, et al. Prostate volume variation with age: community-based survey in namhae region. Korean J Androl. 2001. 19:119–123.

19. Kim BS, Lee JW, Kim YT, Park HY, Kwon SW, Lee TY. The prevalence and risk factors of nocturia for males participating in a prostate examination survey. Korean J Urol. 2008. 49:818–825.