Voiding Parameters Remain Stable in Elderly Men

SAN DIEGO—Lower urinary tract symptoms remain stable over a two-year period among elderly community-living men, according to a population-based study of elderly men presented at the American Urological Association annual meeting.

Consequently, if men are not bothered by their symptoms, they do not necessarily need intervention, said lead investigator Rachel C. Esler, MD, of the University of Sydney in Australia, who presented study findings.

“A lot of these patients don't actually change with their voiding symptoms over a long period,” Dr. Esler told Renal & Urology News, who added that many of these men came in for office visits with poor urine flow rates and did not have treatment. “The vast majority of them required no intervention.”

Dr. Esler and colleagues studied 1,705 men aged 70 years and older participating in the Concord Health and Ageing in Men Project, a population-based study of men living in a defined geographic area in metropolitan Sydney. At initial assessment, subjects ranged in age from 70 to 97. Of the 1,705 men, 1,366 presented for follow-up assessment two years later.

At baseline, the median International Prostate Symptom Score was 5, with 63%, 30%, and 7% of participants suffering from mild, moderate, and severe symptoms, respectively. These proportions remained unchanged at two years.

The median peak flow rate at baseline was 14 mL/sec; this declined to 10.5 mL/sec at two years. The peak flow rate was significantly lower in men older than 85 compared with men aged 70-74 both at baseline and two years later. The median post-void residual (PVR) volume was 38 mL at baseline and 52 mL at two years, with a statistically significant difference only in the men older than 85. Three quarters of men had a PVR volume less than 100 mL; 19% had a PVR volume of 101-200 mL and 6% had a PVR volume greater than 301 mL. Sixty-three men (4.6%) underwent surgery for lower urinary tract symptoms in the interval between baseline and the two-year follow-up.

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