Importance of Relieving the Most Bothersome Symptom for Improving Quality of Life in Male Patients With Lower Urinary Tract Symptoms

Abstract

OBJECTIVE To highlight the importance of relieving the most bothersome symptom for improving quality of life (QoL) in male patients with lower urinary tract symptoms. METHODS From January 2010 to March 2011, 242 men with lower urinary tract symptoms visited our clinic, and 194 finished this study. At first visit, the most bothersome symptom was selected as the "core symptom." The sum of other symptoms except the core symptom was defined as "peripheral symptoms." All patients underwent empirical medical treatment for male lower urinary tract symptoms during an 8- to 12-week period, thereafter, recorded a follow-up International Prostate Symptom Score (I-PSS) questionnaire. We multivariately analyzed the patients' data after medical treatment to assess the influence of relieving their core symptom on the improvement of QoL. RESULTS The patients' mean age was 64.7 years and the mean total I-PSS was 19.7 points. Nocturia was the most common core symptom (29.9%), followed by weak stream (16.5%). Multiple logistic regression revealed that relieving the core symptom (odds ratio [OR] = 39.163, 95% confidence interval [CI] = 13.536-113.309) was significantly associated with QoL improvement. Improvement of peripheral symptoms (OR = 4.849, 95% CI = 1.629-14.433) and the inclusion of the moderate symptom group at first visit (OR = 2.622, 95% CI = 1.009-6.811) were also significant factors in predicting QoL improvement. CONCLUSION In treating benign prostatic hyperplasia or lower urinary tract symptoms, we should focus more on relieving the individual patient's most bothersome symptom to help improve patient QoL. UROLOGY 80: 684-688, 2012. (c) 2012 Elsevier Inc.