Prevalence of hesitancy in 30-80-year-old Finnish men: Tampere Ageing Male Urological Study (TAMUS).
ABSTRACT Study Type--Therapy (symptom prevalence). Level of Evidence 2a. What's known on the subject? and What does the study add? In several population-based studies the prevalence of hesitancy has varied from 20% to 52%. Studies concern mostly older men ≥50-years-old. Knowledge of troublesomeness that hesitancy causes is very scarce. This is a large population-based study on hesitancy in men with a wide age range. This study reports the prevalence of hesitancy from 30-year-old men to 80-year-old men. The bother of hesitancy is reported and this is also presented in different age groups.
• To estimate the prevalence and bother of hesitancy by age group.
• In this population-based study, the target population was 30- to 80-year-old men from Pirkanmaa County, Finland. • Information was collected by means of a mailed self-administered questionnaire in 2004. The overall participation proportion was 58.7% (4384 men out of 7470). • The Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire was used to evaluate urinary symptoms, particularly hesitancy. Logistic regression was used for multivariate analysis.
• Almost half of the men (46.8%, 95% CI 45.3-48.3%) reported hesitancy at least occasionally, but only 0.5% (95% CI 0.3-0.7%) had hesitancy every time they urinated. The prevalence of any hesitancy was 42.3% at 30 years and 50.5% at 80 years of age (trend P < 0.001). Only a few men reported hesitancy often or always, prevalence increasing with age from 2.6% to 11.4% (trend P < 0.001). • Hesitancy caused a small problem for 18.3% of the men and a moderate or major problem for 0.9-5.3%. Only 3% of the men with infrequent hesitancy reported more than a small problem, whereas 59% of the men with hesitancy often or always reported a small problem and 32% reported a moderate or major problem. • Two other voiding symptoms, straining and weak stream, were strongly associated with hesitancy (with odds ratios exceeding 80).
• Mild hesitancy is very common in men of all ages. • Severe cases are rare, but the prevalence increases with age. • Hesitancy is a well-tolerated urinary symptom.
- [show abstract] [hide abstract]
ABSTRACT: To describe changes in the prevalence and severity of urinary symptoms and the degree of interference they cause in the daily life of the Finnish male population by means of a 5-year follow-up study. A postal survey of a stratified random population sample of elderly men in Pirkanmaa County was carried out in 1994 and 1999. A total of 3143 men in 1994 and 2837 in 1999 received the questionnaire; 2198 (70%) and 2133 (75%) responded, respectively. The questionnaire included items on sociodemographic status, overall health and diseases, urinary symptoms (Danish Prostatic Symptom Score), sexual function and bothersomeness of symptoms. Data from those individuals who responded adequately to both inquiries were analysed. The most prevalent urinary symptoms were post-micturition dribble (64%), nocturia (62%), hesitancy (50%) and incomplete emptying (46%). At the 5-year follow-up, the prevalences of hesitancy, incomplete emptying, nocturia, urge incontinence and stress incontinence had increased statistically significantly. Subjects who had been symptomatic at baseline reported no change in 46-77% of cases, deterioration in 2-19% and improvement in 16-52%. The degree of interference in daily activities due to urinary symptoms increased significantly during follow-up. The mean interference index increased from 2.3 to 4.4. Although urinary symptoms in elderly males are particularly common and their prevalence increases with age, they are mostly mild and also have a marked tendency to improve with time. The total burden of urinary symptoms nonetheless increases with age in the elderly male population.Scandinavian Journal of Urology and Nephrology 02/2004; 38(5):378-84. · 1.01 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: Benign prostatic hypertrophy has a high prevalence in men aged > or = 50, but there is little information on the correlates of obstructive symptoms. The prevalence and correlates of reported prostatic symptoms in men aged > or = 50 years were studied in a community survey in the Kiryat Hayovel neighbourhood of Jerusalem in 1985-1987. Five prostate-related questions were asked. Two indices of emotional health were used: the Psychiatric Epidemiology Research Interview demoralization scale and a scale based on the Cornell Medical Index. Associations with sociodemographic, behavioural, emotional, biochemical and physical variables and with self-appraised health were examined both controlling for age only and by multivariate logistic regression. The prevalence rates in the 839 respondents were 20.4% for hesitancy, 41.1% for weak stream, and 26.7% for terminal dribbling; the rates tended to increase with age. The associations between the symptoms (controlling for age) were significant, the strongest being between hesitancy and weak stream. All three of the urinary symptoms were associated with indices of emotional distress. In the multivariate analysis, the odds ratios when men in the highest and lowest quartiles of emotional ill health were compared were 3.0 for hesitancy, 2.2 for weak stream, and 3.8 for dribbling. Specific symptoms were associated with blood pressure, social class and educational level. The striking associations with emotional ill health underline the importance of appropriate attention to the emotional health of patients who complain of prostatic symptoms.International Journal of Epidemiology 08/1994; 23(4):797-804. · 6.98 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: Detrusor instability is a common urodynamic finding in patients with prostatic obstruction. In prospective fashion we evaluated detrusor instability in patients with lower urinary tract symptoms attributable to benign prostatic hyperplasia and determined its possible association with the degree of obstruction. A total of 459 men with a mean age plus or minus standard deviation of 60.4 +/- 9.4 years who were investigated for lower urinary tract symptoms at our facility answered an Arabic standardized version of International Prostate Symptom Score and underwent simple uroflowmetry, outpatient cystoscopy and transrectal ultrasound. Invasive urodynamics, including filling and voiding cystometry, was done with pressure flow analysis according to the Schäfer nomogram. Statistical significance was tested by the Mann-Whitney U and Wilcoxon rank sum tests. Of the 459 patients 108 (23.5%) had detrusor instability. Instability significantly affected patient symptom score and conception of quality of life. Moreover, instability significantly affected the degree of obstruction, as measured by the maximum flow rate, post-void residual urine, prostate volume and Schäfer grade of obstruction. Detrusor instability affects patient symptoms and quality of life. It also signifies a more severe degree of obstruction in male patients with lower urinary tract symptoms and bladder outlet obstruction due to benign prostatic hyperplasia.The Journal of Urology 08/2002; 168(1):132-4. · 3.70 Impact Factor