Relative importance of sexuality and quality of life in patients with prostatic symptoms. Results of an international study.

OBJECTIVE: Benign prostatic hyperplasia (BPH) and its treatment can impair the quality of life (QoL) of patients with the condition. Among the BPH-specific instruments available for assessing QoL, no consensus has emerged on the concepts that should be measured, particularly for aspects of sexual life. The objective of this study was to determine which aspects of QoL were most affected by prostatic symptoms and which patients considered the most important. METHOD: After an extensive literature review, we drew up a self-administered questionnaire composed of an exhaustive list of concepts found in the available QoL/BPH measures. In a cross-sectional study, 73 French and 44 English patients with an International Prostate Score (I-PSS) > 7 were asked to fill in this 89-item questionnaire. The level of interference of the symptoms with each aspect of QoL and the importance of the problem were reported by the patients. RESULTS: The aspects reported to be most affected and to be the most important were sleep, anxiety and worry about the disease, mobility, leisure, daily activities, sexual activities and satisfaction with sexual relationships. French patients considered all sexual aspects of life more important than English patients. CONCLUSION: This study confirms that QoL is an important outcome in BPH. The major concepts identified by the patients to be important include sexual ones. These results suggest the importance of including the assessment of sexual functioning and behavior in any further evaluations of BPH treatments effects on QoL.