Correlations among Lower Urinary Tract Symptoms, Bother, and Quality of Life in Patients with Benign Prostatic Hyperplasia and Associated Fluctuations with Tamsulosin Administration.

ABSTRACT

OBJECTIVES: To estimate correlations among lower urinary tract symptoms (LUTS), bother, and quality of life (QOL) and assess fluctuations in these parameters after α1-blocker administration in patients with benign prostatic hyperplasia (BPH). METHODS: Untreated BPH patients with international prostate symptom scores (IPSS) ≥ 8 and IPSS-QOL scores ≥ 2 were administered tamsulosin at 0.2 mg/day for 4 weeks in a prospective multicenter study. We subsequently estimated the IPSS, bother score for each IPSS item, BPH impact index (BII), and IPSS-QOL score before and 4 weeks after tamsulosin administration. We also analyzed the LUTS that might strongly influence QOL by using a path analysis model. RESULTS: Analyzable data were obtained from 198 of the 257 patients enrolled. The IPSS were highest for LUTS such as slow stream, followed by increased daytime frequency and nocturia. The bother score was highest for slow stream, followed by nocturia. We observed dissociations between IPSS and bother scores for both urgency and nocturia. After tamsulosin administration, total and individual IPSS, total and individual bother scores, total and individual BII scores, and IPSS-QOL score demonstrated significant improvements. Path analysis showed that physical discomfort and bothersomeness were BII items that strongly influenced QOL. Furthermore, feeling of incomplete emptying, urgency, and slow stream were LUTS that strongly influenced QOL. CONCLUSION: Tamsulosin administration improved patient QOL by possible mechanisms via improvement in subjective symptoms and bother. The LUTS that strongly influenced QOL comprised feeling of incomplete emptying, urgency, and slow stream.