A Study On The Changes Of Quality Of Life, IIEF-5, LUTS And Uroflowmetry And Their Correlation In Patients With BPH In Different Dimensions Of Disease

Objective:To compare the quality of life, erectile function, lower urinary tract symptoms’and uroflowmetry in four groups such as benign prostatic hyperplasia simplex(BPH simplex), BPH with diabetes mellitus (DM) and hypertension, BPH with DM and BPH with hypertension. And to evaluate the relation between quality of life, erectile function, lower urinary tract symptoms and uroflowmetry in each group.Methods:110patients (range48-89years), diagnosed as BPH and having complete data, were included in the study from October2011to April2012in Department of Urology, Affiliated Drum Tower Hospital, Medical College of Nanjing University. History-taking was carried out face to face, and quality of life, erectile function and lower urinary tract symptoms were estimated by The Medical Outcomes Study36-ltem Short-Form Health Survey(SF-36), International Index of Erectile Function(IIEF-5), International Prostate Symptom Score (IPSS) respectively. The maximum flow rate(Qmax), flow time and total volume of urine were measured by Laborie urodynamic apparatus. Relative voiding resistance=flow time/Qmax.Results:No statistical difference was found in age in the four groups(P=0.150).In8domains of SF-36, only general health was observed with significant difference among four groups (P=0.008), and further analysis revealed that the general health in BPH with DM and hypertension group was inferior to BPH simplex group (x2=10.41,0.01<P<0.025) and BPH with hypertension group (x2=8.14,0.025<P<0.05), but the rest were not significant difference each other. IIEF-5was on the border of significant difference among four groups (P=0.051) There were no significant difference in IPSS or uroflowmetry among four groups (P>0.05)Mental health was positively correlated with age only, not correlated with any other factor in the study, in the BPH simplex group, BPH with DM and hypertension group and BPH with hypertension group. Mental health was not correlated with age, but correlated negatively with IPSS storage score and IPSS quality of life score(IPSS-QoL) in BPH with DM group. IIEF-5was positively correlated with both physical functioning and role-physical in the BPH simplex group and BPH with DM and hypertension group, but not correlated with any domain of SF-36in BPH with DM group or BPH with hypertension group. General health was negatively correlated with IPSS total score, IPSS voiding score and IPSS-QoL in BPH simplex group, but not correlated with any factor in the study in the other three groups. Qmax was positively correlated with both physical functioning and role-physical in the BPH simplex group, but not correlated with physical functioning or role-physical in the other three groups. Qmax was negatively correlated with both social functioning and role-emotional in the BPH with hypertension group, but not correlated with social functioning or role-emotional in the other three groups. Bodily pain was not correlated with any factor in the study in any group(P>0.05).Age was not correlated with any IPSS score in the BPH simplex group or BPH with DM and hypertension group, but correlated positively with both IPSS total score and IPSS voiding score in BPH with DM group, and correlated extremely positively with IPSS storage score in BPH with hypertension group. Age was negatively correlated with both IIEF-5and total volume of urine in the BPH simplex group, but not correlated with IIEF-5or any uroflowmetry parameter in the other three groups. IIEF-5" was negatively correlated with IPSS total score, IPSS storage score, IPSS voiding score and IPSS-QoL in the BPH simplex group, but correlated negatively with IPSS-QoL only in BPH with DM group, and correlated positively with IPSS-QoL only in BPH with hypertension group. There was no significant correlation between IIEF-5and any IPSS score in BPH with DM and hypertension group. IIEF-5was positively correlated with both total volume of urine and Qmax and correlated negatively with relative voiding resistance in the BPH simplex group, but not correlated with any uroflowmetry parameter in the other three groups. Any IPSS score was correlated significantly with any uroflowmetry parameter in the BPH simplex group, but only IPSS-QoL was correlated significantly with Qmax in the BPH with DM and hypertension group.Conclusion:Basal disease such as DM or hypertension has certain impact on the quality of life of patients with BPH. When merged with DM or hypertension, the patients’erectile function decreases further. The relation between age, quality of life, IIEF-5, IPSS and uroflowmetry varies greatly due to the patients’different dimensions of disease.