Perception of benign prostatic hyperplasia (BPH): Cultural differences in symptoms and impact

Roger Kirby, Claus Roehrborn, Peter Boyle, Georg Bartsch, Alain Jardin

Research output: Contribution to journalArticlepeer-review


INTRODUCTION AND AIMS OF STUDY: Linie information is available on how cultural background affects perception of BPH. This study aimed to compare the baseline BPH Impact Index (BII) in BPH patients from five European countries enrolled into the Prospective European Doxazosin and Combination Trial (PREDICT). PATIENTS AND METHODS: Patients, aged ≥ 49 years with International Prostate Symptom Score (I-PSS) > 12 and peak urinary flow rate (Qmax) < 15 ml/s, from France, Germany, Holland, Italy, and the UK. were investigated. Data on BII were gained using self-reported questionnaires covering BPH-related aspects such as bothersomeness, physical discomfort, restrictions on usual activities, and health concerns. Prostate size was estimated by digital rectal examination or ultrasound. RESULTS: 826 BPH patients were enrolled. France Germany Holland Italy UK All (n=H8) (n=2J6) (n=50) (n=H7) (n=325) (n=826) Age (y) 62.7 65.1 64.4 63.5 64.9 64.4 I-PSS 16.2 17.7 17.6 17.4 17.1 17.2 Qmax (ml/s) 10.7 10.8 10.2 10.7 10.3 10.5 BII 4.1 6.7 5.8 6.0 4.6 5.4 Baseline severity of BPH was comparable between countries with no statistically significant differences observed in I-PSS or Qmax. However, BII was statistically significantly greater in German and Italian men compared with French and UK men (p<0.05 in all cases). Estimated mean (±SD) prostate size was 36.8 (14.6) grams by digital rectal examination and 47.1 (20.1) grams by ultrasound. CONCLUSIONS: The perceived impact of BPH symptoms was markedly different in men from different countries. Lowest impact of BPH was seen in the French and UK men, while highest impact was for German and Italian men. These cultural differences are likely to have an impact on treatment outcomes in terms of patient satisfaction even though baseline BPH severity as measured by the I-PSS between countries is the same. Further investigations into this interesting area should elucidate cultural, as well as racial, differences in perceptions of BPH as well as how and if these perceptions affect treatment outcomes.

Original languageEnglish (US)
Number of pages1
JournalBritish Journal of Urology
Issue numberSUPPL. 2
StatePublished - 1997

ASJC Scopus subject areas

  • Urology


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