Differences in lower urinary tract symptoms, treatment and mortality among African-American and white elderly men

Abstract

Background: There are limited population-based studies of benign prostate hyperplasia (BPH) and lower urinary tract symptoms (LUTS) in men, and most studies examined to date have been restricted to predominately white populations. This study examines treatment and all-cause mortality among a cohort of African-American and white men aged > or =65 with BPH/LUTS symptoms over time.

Methods: Data were collected from the Piedmont Health Survey of the Elderly-Established Populations for the Epidemiological Study of the Elderly for 5 North Carolina counties from 1994 (N=502) to 1998 (N=322).

Results: From 1994-1998, there were no significant racial differences in treatment by catheter insertion, prostate surgery or drug therapy for BPH/LUTS. However, overall use of the 3 treatments increased from 1994-1998, with drug therapy showing the largest increase. Adjusted analyses revealed racial differences in prostate surgery only, with African-American men nearly 40% more likely to receive prostate surgery than white men. Men with comorbid conditions were less likely to receive drug therapy, whereas those with poor self-reported health or cancer were more likely to receive prostate surgery. Catheter insertion was more likely for those who had resided in a nursing home. Men who received drug therapy treatment or had regular rectal exams showed decreased risk of mortality.

Conclusion: Findings suggest that healthcare providers should direct more attention to the management of LUTS in white and African-American elderly men. Data also demon-strate the need for studies that focus on treatment modalities as well as important correlates of LUTS.