Natural history of prostatism: Longitudinal changes in voiding symptoms in community dwelling men

Purpose: We report the results of 3 contacts during 42 months of The Olmsted County Study of Urinary Symptoms and Health Status Among Men, a longitudinal cohort study of men 40 to 79 years old that was initiated in 1990 to describe changes in lower urinary tract symptom severity. Materials and Methods: At baseline and followup, men completed questionnaires that elicited urinary symptom severity with questions nearly identical to those of the American Urological Association symptom index. Results: Overall, there was an average increase in American Urological Association symptom index of approximately 0.18 (95% confidence interval 0.13 to 0.24) points per year of followup. The average annual symptom score slope and variability in slope increased with patient age at baseline from a mean of 0.05 +/- 1.06 (standard deviation) per year among men in the forties to 0.44 +/- 1.35 per year for men in the sixties, and decreased to 0.14 +/- 1.42 per year for men in the seventies. The age-related changes in symptom severity mirror previous estimates of prostatic growth from autopsy prevalence studies. Conclusions: These results demonstrate a slow but measurable progression in urinary symptom severity among community dwelling men for 42 months of followup.