Factors Influencing Health-related Quality of Life in Patients with Benign Prostatic Hyperplasia

PURPOSE: This study was done to examine the relationship of low urinary tract symptoms (LUTS), depression, sexual function, and health-related quality of life (HRQoL), and to identify factors influencing HRQoL in patients with benign prostatic hyperplasia (BPH) living in the community. METHODS: A total of 218 patients with BPH were recruited into the study. The data were collected by personal interviews using questionnaires and were analyzed with SPSS (version 17.0) computer program, and included descriptive statistics, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis. RESULTS: The relationship between HRQoL and LUTS with depression had a significant negative correlation, whereas the relationship between HRQoL and sexual function had a significant positive correlation. Depression, age, LUTS, number of chronic disease, and excercise were found to be significant predictors (35.6%) of the Physical Component Summary of HRQoL. Depression, stress, smoking, LUTS, and sexual function were found to be significant predictors (48.2%) of the Mental Component Summary of HRQoL. CONCLUSION: To improve HRQoL of patients with BPH, nurses should focus on the factors identified in this study when doing nursing assessments, and should develop nursing intervention programs for BPH prevention and symptoms management in primary care settings.

Noninvasive treatment of benign prostatic hyperplasia. Where do we stand in 2005

Noninvasive treatment of lower urinary tract symptoms [LUTS] due to benign prostatic hyperplasia [BPH] includes self-management and medical treatment. Self-management should be encouraged as an initial step for all men with uncomplicated LUTS/BPH. It consists of 3 elements, namely: education and reassurance, lifestyle modification of fluid intake and concurrent medical therapy and finally behavioral interventions including management of post-void dribbling and bladder retraining. If self-management fails, medical or surgical interventions are required. Further, research is required to define and test the effectiveness of self-management either as a primary intervention or to augment existing medical therapies. Benign prostatic hyperplasia patients in need of rapid onset of symptom relief and those with small prostates benefit from the use of alpha-blockers. Although 5-alpha-reductase inhibitors [5 ARIs] provide symptomatic benefits, the onsets of these are slower than those observed with the alpha-blockers. Amongst available therapies, only 5 ARIs have been shown to reduce the risk of acute urine retention [AUR] and BPH-related surgery compared to placebo. The Medical Therapy of Prostatic Symptoms [MTOPS] Study provides rational basis for combined alpha-blockers plus 5 ARIs in patients with a high index of disease progression [prostate volume >30 g and prostate-specific antigen >1.6 ng/ml]. Preliminary studies suggest that anticholinergics could be safe in LUTS/BPH and can help to alleviate irritative bladder symptoms due to overactive bladders commonly associated with BPH