Incidence, prevalence and management of lower urinary tract symptoms in men in the UK

OBJECTIVE To describe the incidence, prevalence and management of lower urinary tract symptoms (LUTS), suggestive of benign prostatic hyperplasia, reported in UK general practice. PATIENTS AND METHODS All clinical information relating to LUTS and its treatment was assessed for men aged greater than or equal to45 years and registered on the UK General Practice Research Database (GPRD) at some time between 1992 and 2001. Incidence and prevalence were derived from the GPRD population. Secular trends in the management of LUTS were examined from prescribing rates and the intervals between first symptoms, first treatment and surgery or catheterization. RESULTS The incidence of reported LUTS showed a strong linear increase with age. The prevalence increased from 3.5% for men aged 45-49 years to >30% for men aged >85 years. Between 1992 and 2000 there was a five-fold increase in the proportion of time with LUTS when men were receiving medical treatment. This was accompanied by a progressive decrease in the intervals between first symptoms and first drug treatment, and a significant increase in the intervals from first symptoms or first treatment to surgery or catheterization. Treated men received surgery or catheterization significantly later than those receiving no drug treatment. CONCLUSION There has been a significant increase in the use of medical therapy for LUTS over the last decade. The accompanying postponement of surgery/catheterization is likely to be a result, at least in part, of successful earlier medical treatment and the treatment of a greater proportion of symptomatic men.