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Symptoms and signs of prostatism as risk factors for prostatectomy
Author(s) -
Arrighi H. M.,
Guess H. A.,
Metter E. J.,
Fozard J. L.
Publication year - 1990
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.2990160309
Subject(s) - prostatism , medicine , prostatectomy , open prostatectomy , urology , rectal examination , palpation , prostate , risk factor , hyperplasia , surgery , prostate disease , cancer
Symptom questionnaires and physical examinations administered periodically to 1,057 men followed prospectively for up to 30 years in the Baltimore Longitudinal Study of Aging (BLSA) were analyzed to determine which symptoms of prostatism were predictive of subsequent prostatectomy for benign prostatic hyperplasia (BPH). Change in the size and force of the urinary stream ( P = 0.0001) and a sensation of incomplete emptying ( P = 0.0005) were the only symptoms positively predictive in a multivariate analysis. Prostate enlargement by rectal palpation was an independent risk factor for prostatectomy ( P <0.03) and was associated with hesitancy ( P <0.02) and a sensation of incomplete emptying ( P <0.02). Of the men with all three risk factors, 37% (41/112) eventually had a prostatectomy, in contrast to 8% of the remaining 945 men. This is the first study to document the extent to which urologic symptoms and a digital rectal examination predict subsequent prostatectomy for BPH.