Elsevier

Urology

Volume 66, Issue 5, November 2005, Pages 964-970
Urology

Adult urology
Correlates and prevalence of prostatitis in a large community-based cohort of older men

This study was presented in part at the Annual Meeting of the American Urological Association, San Francisco, May 8–13, 2004 (podium session presentation).
https://doi.org/10.1016/j.urology.2005.05.034Get rights and content

Abstract

Objectives

To describe the prevalence and correlates of self-reported history of prostatitis in terms of lower urinary tract symptoms and associated dissatisfaction in community-dwelling older men.

Methods

We performed a cross-sectional analysis from a prospective cohort study of 5821 men aged 65 years and older recruited from six clinical centers.

Results

Overall, 1439 men (25%) self-reported a history of prostatitis. Men with a history of prostatitis were more likely to self-report a history of prostate cancer (26% versus 7%; P <0.0001) and a history of benign prostatic hyperplasia (83% versus 38%; P <0.0001) within a lifetime compared with men without a history of prostatitis. Men with a history of prostatitis also had a greater mean American Urological Association symptom score (mean ± SD, 10.1 ± 7.1 versus 7.7 ± 5.9; P <0.0001) than men without a history of prostatitis. Also, a greater percentage of men with a history of prostatitis reported being dissatisfied with their present urinary condition than did men without a history of prostatitis (21% versus 11%; P <0.0001). We found positive associations for a history of prostatitis with a history of benign prostatic hyperplasia (odds ratio 8.0, 95% confidence interval 6.8 to 9.5), a history of prostate cancer (odds ratio 5.4, 95% confidence interval 4.4 to 6.6), and dissatisfaction with current urinary condition (odds ratio 1.2, 95% confidence interval 1.01 to 1.5).

Conclusions

A self-reported history of prostatitis is common in older men and was associated with self-reported prostate cancer and benign prostatic hyperplasia and increased severity of lower urinary tract symptoms and associated dissatisfaction. Because of the potential detection bias, recall bias, and the cross-sectional nature of the study, limiting causal inference, the associations among these urologic conditions require additional study.

Section snippets

Material and methods

We conducted a cross-sectional analysis of baseline data from a prospective cohort study of 5821 men enrolled in the MrOS study. We excluded 174 men who were not white, African American, or Asian, because the number of men in other categories were too few for stratified analyses. The MrOS study is a community-based study of 5995 men from six clinical centers in the United States. To be an MrOS participant, men had to be at least 65 years old, able to walk without the assistance of another

Results

Overall, 1439 men (25%) reported a history of prostatitis. The racial prevalence distribution of prostatitis was 25% for white men, 23% for African-American men, and 17% for Asian men (P = 0.02). The prevalence of prostatitis by age category was 19% for those younger than 70 years, 25% for those 70 to 79 years, and 33% for those 80 years or older (P <0.0001).

The baseline characteristics of men with and without a history of prostatitis are compared in Table I. Men with a history of prostatitis

Comment

A self-reported history of prostatitis is associated with self-reported prostate cancer and BPH and increased severity of LUTS and associated dissatisfaction. Because of the cross-sectional nature of the data, our findings do not suggest causality but do call for additional research into the relationship of prostatitis to other diseases of the prostate. The associations among these urologic conditions may reflect increased diagnostic surveillance for other prostatic diseases once one prostatic

Conclusions

Our study results have shown that a self-reported history of prostatitis is associated with self-reported prostate cancer and BPH and increased severity of LUTS and associated dissatisfaction. Understanding the associations between prostatitis and BPH and incident prostate cancer requires additional prospective studies to determine whether symptom-driven screening would be case finding and whether effective treatment of prostatitis would lead to a reduction in prostate cancer incidence,

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This project was funded by the National Institutes of Health (NIH grants UO1 AG18197-02, UO1 AR45580-02, UO1 AR45614, UO1 AR45632, UO1 AR45647, UO1 AR45654, UO1 AR45583, and M01 RR00334). Dr. Daniels is a recipient of the Robert Wood Johnson Minority Medical Faculty Development Award and supported by grant P30-AG15272 under the Resource Centers for Minority Aging Research program funded by the National Institute on Aging, the National Institute of Nursing Research, and the National Center on Minority Health and Health Disparities, National Institutes of Health, and the Department of Defense Prostate Scholar Award.

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