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H A Guess

Publications and source records attributed to H A Guess.

At least 19 recordsLinked to original sources
PubMed1998

Health-related quality of life associated with lower urinary tract symptoms in four countries.

OBJECTIVES: To describe health-related quality of life (HRQL) associated with lower urinary tract symptoms (LUTS) assessed by validated questionnaires in four countries. METHODS: More than 6000 men, recruited by using community- or population-based sampling in four countries, completed questionnaires soliciting information about urinary symptom frequency, bother, degree of interference with daily activities, and other measures of HRQL. RESULTS: In all countries, disease-specific HRQL worsened with increasing age. Adjusting for age, most disease-specific HRQL measures were significantly worse with increasing symptom severity. The correlation between symptoms and HRQL was strongest in countries with higher prevalence of symptoms, such as Japan or the United States, and less pronounced in countries with lower prevalence (France, Scotland), possibly reflecting the lower variability in scores. CONCLUSIONS: HRQL measures are worse in older men, and increased urinary symptom severity is associated with worse disease-specific HRQL in all countries, despite potential cross-cultural differences in disease prevalence, medication use, perceptions, or willingness to report symptoms or worse HRQL. This cross-cultural consistency suggests that an assessment of symptom bother or interference with daily activities may be useful in patient evaluation.

Adult↗
PubMed1998

Screening digital rectal examination and prostate cancer mortality: a population-based case-control study.

OBJECTIVES: Although digital rectal examination (DRE) for the detection of prostate cancer has been recommended by many professional groups and has become part of the general physical examination, no randomized clinical trial has demonstrated the efficacy or effectiveness of this practice. We conducted a population-based case-control study to evaluate the association between DRE and prostate cancer mortality. METHODS: With the resources of the Rochester Epidemiology Project, all 173 men who died of prostate cancer in Olmsted County from 1976 to 1991, who were resident at the time of diagnosis, were identified. For each case, two control patients were drawn from the population, matched for residence at the time of diagnosis in the case, birth date, and duration of medical record in Olmsted County. Trained nurse abstractors reviewed the community medical records for up to 10 years before the date of diagnosis in the case for mention of DRE and specific findings associated with each mention. RESULTS: Case subjects were less likely than control subjects to have had any DRE in the 10 years before diagnosis (matched odds ratio [OR] = 0.51; 95% confidence interval [CI] = 0.31, 0.84). When limited to DREs without mention of signs or symptoms that might raise suspicion of prostate cancer, the association was even stronger (OR = 0.31; 95% CI = 0.19, 0.49). Adjustment for educational attainment, marital status, and comorbid conditions did little to alter the associations. CONCLUSIONS: These results demonstrate a strong inverse association between DRE and prostate cancer mortality. If further research concludes this association to be causal, screening DREs may have prevented as many as 50% to 70% of deaths due to prostate cancer that might have occurred in the absence of screening.

Aged↗
PubMed1998

Treatment with finasteride preserves usefulness of prostate-specific antigen in the detection of prostate cancer: results of a randomized, double-blind, placebo-controlled clinical trial. PLESS Study Group. Proscar Long-term Efficacy and Safety Study.

OBJECTIVES: To evaluate prostate cancer detection and prostate-specific antigen (PSA) among men with benign prostatic hyperplasia treated with finasteride. METHODS: Three thousand forty men 45 to 78 years of age with PSA less than 10 ng/mL and no history of prostate cancer were randomized in a double-blind, placebo-controlled trial to finasteride (n = 1524) or placebo (n = 1516) for up to 4 years. A prerandomization biopsy negative for prostate cancer was obtained in 98% of patients with a screening PSA of 4.0 ng/mL or more, and an end-of-study biopsy was requested of all such patients without a recent second negative biopsy or a prostate cancer diagnosis. RESULTS: Overall, 644 patients (21%) underwent biopsy and 201 (6.6%) underwent transurethral resection of the prostate. Prostate cancer was diagnosed in 4.7% of men on finasteride and 5.1% on placebo (P = 0.7). Elevated PSA prompted diagnosis in 35% of cases on finasteride and 34% on placebo. The area under the receiver operating characteristic curve for last PSA was 0.84 on finasteride and 0.79 on placebo (P = 0.07). Use of an upper limit of normal for last PSA of 2.0 ng/mL for finasteride and 4.0 ng/mL for placebo yielded similar sensitivity (66% versus 70%, P = 0.6), higher specificity (82% versus 74%, P < 0.0001), and a higher likelihood ratio (3.6 versus 2.7, P < 0.05) for finasteride than for placebo. CONCLUSIONS: In men treated with finasteride, multiplying PSA by 2 and using normal ranges for untreated men preserves the usefulness of PSA for prostate cancer detection.

Aged↗
PubMed1997

Natural history of prostatism: risk factors for acute urinary retention.

PURPOSE: We determined the occurrence of and risk factors for acute urinary retention in the community setting. MATERIALS AND METHODS: A cohort of 2,115 men 40 to 79 years old was randomly selected from an enumeration of the Olmsted County, Minnesota population (55% response rate). Participants completed a previously validated baseline questionnaire that assessed symptom severity, and voided into a portable urometer to measure peak urinary flow rates. A 25% random subsample underwent transrectal sonographic imaging of the prostate to determine prostate volume. Followup was performed through a retrospective review of community medical records to determine the occurrence of acute urinary retention in the subsequent 4 years. RESULTS: During the 8,344 person-years of followup 57 men had a first episode of acute urinary retention (incidence 6.8/1,000 person-years, 95% confidence interval [CI] 5.2, 8.9). Among men with no to mild symptoms (American Urological Association symptom index score 7 or less) the incidence of acute urinary retention increased from 2.6/1,000 person-years among men 40 to 49 years old to 9.3/1,000 person-years among men 70 to 79 years old. By contrast, rates increased from 3.0/1,000 person-years for men 40 to 49 years old to 34.7/1,000 person-years among men 70 to 79 years old among men with moderate to severe symptoms (American Urological Association symptom index score greater than 7). Men with depressed peak urinary flow rate (less than 12 ml. per second) were at 4 times the risk of acute urinary retention compared with men with urinary flow rates greater than 12 ml. per second (95% CI 2.3, 6.6). Men with an enlarged prostate (greater than 30 ml.) experienced a 3-fold increase in risk (95% CI 1.0, 9.0, p = 0.04). CONCLUSIONS: Lower urinary tract symptoms, depressed peak urinary flow rates, enlarged prostates and older age are associated with an increased risk of acute urinary retention in community dwelling men. These findings may help to identify men at increased risk of acute urinary retention in whom closer evaluation may be warranted.

Acute Disease↗
PubMed1997

Natural history of prostatism: impaired health states in men with lower urinary tract symptoms.

PURPOSE: Lower urinary tract symptoms are reported to have a significant impact on quality of life. However, the impact on specific aspects of health status is not clear. We evaluated the association between lower urinary tract symptoms, and physical and mental aspects of health using community based data from a cross-sectional component of a prospective cohort study. MATERIALS AND METHODS: A total of 2,133 men 41 to 84 years old who were randomly selected from the Olmsted County, Minnesota population completed the 36-item health status questionnaire and a previously validated questionnaire assessing urinary symptoms. Eight domains, measured on a scale of 0 to 100, were used to assess general health status. Men were classified as having an impaired health status if they scored less than 75 points on the scale. Symptom severity (none, mild, moderate or severe) was measured from responses to the urinary symptom questionnaire. RESULTS: The results demonstrated a cross-sectional decrease in mean health status scores for all 8 domains across levels of increasing urinary symptom severity. The strongest associations between health status scores and urinary symptoms (severe versus none) were observed for role limitation due to physical problems (odds ratio 15.7, 95% confidence interval 6.6 to 37.0), energy/fatigue (odds ratio 9.2, 95% confidence interval 4.7 to 18.1), role limitation due to emotional problems (odds ratio 8.7, 95% confidence interval 4.1 to 18.2) and general perception of health (odds ratio 7.2, 95% confidence interval 3.8 to 13.4). For these 4 dimensions men with mild urinary symptoms were also significantly more likely to have an impaired health status. Adjustment for age and co-morbidity did not alter the results. CONCLUSIONS: These findings suggest that urinary symptoms have a multidimensional association with physical and mental aspects of health. Although lower urinary tract symptoms may be the cause of an impaired health status, men with impaired health conditions may be more sensitive to prevalent urinary symptoms and more likely to report them. While the casual nature of this association has not been ascertained, these results may help to identify appropriate health dimensions to assess in patients with lower urinary tract symptoms.

Adult↗
PubMed1997

Validation of a questionnaire for comparing the tolerability of ophthalmic medications.

PURPOSE: The Comparison of Ophthalmic Medications for Tolerability (COMTOL) questionnaire was developed for use in clinical trials to compare the tolerability of topical ophthalmic medications used in the treatment of glaucoma. The questionnaire captures the frequency and bother of common side effects (i.e., ocular and other local effects, and effects on visual function) of topical therapy for lowering intraocular pressure. In addition, the questionnaire measures the extent to which these side effects and any associated limitations in routine living activities interfere with health-related quality of life, medication compliance, and patient satisfaction with the medication. This study was designed to assess the measurement characteristics of the COMTOL questionnaire. METHODS: The internal consistency, reliability, reproducibility, construct validity, discriminant validity, and responsiveness of the questionnaire were assessed in 70 adult patients with glaucoma in a clinical trial comparing timolol and pilocarpine. RESULTS: The questionnaire showed good-to-excellent internal consistency (0.73 to 0.98), reliability (0.76 to 0.94), and reproducibility (0.75 to 0.93). In general, there was a strong correlation in the expected direction between the frequency and bother of side effects and patient-perceived global measures. The questionnaire discriminated between patients receiving timolol and patients receiving pilocarpine. The questionnaire demonstrated significant responsiveness to change. CONCLUSIONS: The COMTOL questionnaire showed acceptable measurement characteristics for inclusion as a tolerability measure to supplement spontaneous adverse event reporting in clinical trials of topical ophthalmic therapy.

Adrenergic beta-Antagonists↗
PubMed1997

Demographics, health behaviors, and past drug use as predictors of recall accuracy for previous prescription medication use.

Drug data for pharmacoepidemiologic studies are often ascertained by self-report, but little research has addressed the factors influencing its accuracy. Stratified random sampling was used to select individuals for a study comparing interview data on past prescription drug use with dispensation information from the Group Health Cooperative of Puget Sound pharmacy database. The strata included age, gender, and recency of use. Recall accuracy and its determinants were evaluated for repetitively used non-steroidal anti-inflammatory drugs (NSAIDs), short-term NSAIDs (only a single dispensation), and post-menopausal estrogens. We investigated whether recall accuracy was influenced by education, marital status, race, smoking, alcohol consumption, cumulative drug history, the number of different NSAIDs or estrogens dispensed (both by name and dosage), and the number of dispensations of the drug in question. For repetitively used NSAIDs, recall accuracy was positively associated with the number of NSAID dispensations (the odds of recall were 1.7 [95% confidence interval {CL}: 1.3-2.2] times greater for each additional four dispensations of the NSAID), the total number of drugs dispensed and the number of different NSAIDs dispensed. For estrogen and short-term NSAID use, only higher educational attainment improved recall accuracy: the odds of recall were 4.1 (95% CI: 1.4-11.7) and 2.1 (95% CI: 1.0-4.7) times greater for those with some college compared with those with only a high school degree, respectively. This study demonstrates that predictors of recall accuracy for previous medication use differ by the type of drug and the repetitiveness of its use.

Aged↗
PubMed1997

5 alpha-reductase activity and prostate cancer: a case-control study using stored sera.

We report a nested case-control study of serum biomarkers of 5 alpha-reductase activity and the incidence of prostate cancer. From a cohort of more than 125,000 members of the Kaiser Permanente Medical Care Program who underwent multiphasic health examinations during 1964-1971, we selected 106 incident prostate cancer cases. A control was pair matched to each case on age, date of serum sampling, and clinic location. Serum levels of total testosterone, free testosterone, androsterone glucuronide, and 5 alpha-androstane-3 alpha,17 beta androstanediol glucuronide (3 alpha-diol G) were measured on the stored samples and scored as quartiles. Potential confounders included alcohol, smoking, and body mass index. The adjusted odds ratios and 95% confidence intervals for a one quartile score increase were 1.00 (0.75-1.34) for total testosterone, 1.14 (0.86-1.50) for free testosterone, 1.13 (0.84-1.53) for androsterone glucuronide, and 1.16 (0.86-1.56) for 3 alpha-diol G. A limitation of this study is that there are two different 5 alpha-reductase isoenzymes, only one of which is expressed in high levels within the prostate, yet both of which may affect serum biomarkers. Since the two isoenzymes are encoded on different chromosomes, variation in one would act as an independent source of measurement error in any analysis of serum biomarker effects of the other. Consequently, the odds ratios may be underestimated and the study, although negative, cannot exclude the previously hypothesized possibility that a positive relationship between intraprostatic 5 alpha-reductase activity and prostate cancer may exist. A clinical trial to test this hypothesis is under way.

Aged↗
PubMed1997

Age-related differences in internal prostatic architecture on transrectal ultrasonography: results of a community based survey in Japan.

PURPOSE: We determined age-related differences in prostate internal architecture and prostate volume by transrectal ultrasonography in Japanese men 40 to 79 years old. MATERIALS AND METHODS: The 287 study participants were categorized by transition zone disease: group 1-not visible (normal prostate), group 2-visible, borders unclear (diffusely enlarged hyperplasia) and group 3-visible, border clear (nodularly enlarged hyperplasia). RESULTS: Group 1 comprised 40% of men 50 to 79 years old and showed slightly decreased median prostate volume with age. Prostate volume and its variance increased with age in group 3 but differed little across age in group 2. CONCLUSIONS: In a community sample the prostatic internal architecture relationship with age and prostate volume suggested differing growth patterns.

Adult↗
PubMed1996

Predictive properties of serum-prostate-specific antigen testing in a community-based setting.

BACKGROUND: Most studies that have described the sensitivity and specificity of prostate-specific antigen (PSA) as a screening test have been conducted in urology practice settings or in media-based screening programs. The control patients from these settings may have a higher prevalence of urologic disorders that increase serum PSA levels than that of the general population in which screening efforts might take place, leading to biased estimates of sensitivity and specificity. OBJECTIVE: To determine the sensitivity and specificity of serum PSA levels for the early detection of prostate cancer in a population-based setting. PATIENTS AND METHODS: This population-based case-control study was conducted in Olmsted County, Minnesota, where the Rochester Epidemiology Project could identify all incident cases of prostate cancer through passive surveillance of medical care provided to local residents. Case patients were all 177 men (age range, 50-79 years) who were newly diagnosed as having prostate cancer from 1990 through 1992 and had a prediagnostic serum PSA determination (90% of all incident cases). Control patients were randomly selected from the Olmsted County population and had undergone a clinical examination to exclude prostate cancer. RESULTS: The median (25th and 75th percentiles) of serum PSA levels was 9.4 ng/mL (5.4 and 18.6 ng/mL, respectively) for case patients and 1.2 ng/mL (0.7 and 2.1 ng/mL, respectively) for control patients (P < .001). When sensitivity was plotted against 1-specificity, the area under the receiver operating characteristic curve was 0.94 (SE, 0.01). The predictive power declined somewhat with age, with areas under the curve of 0.96, 0.94, and 0.90 for men in their 50s, 60s, and 70s, respectively. When cases were restricted to the 155 men with clinically localized disease, the area under the curve was essentially unchanged (0.94; SE, 0.01) and still much greater than the estimates of 0.75 that were reported from urology practice- and media-based settings. CONCLUSIONS: In a community-based setting, serum PSA levels provide better discrimination between men with and without clinically localized prostate cancer than has been observed in studies that were conducted in urologic practices. These results suggest that previous decision analyses may have underestimated the predictive value of PSA for the detection of prostate cancer in a primary care or community-wide screening program.

Age Factors↗
PubMed1996

Adverse effects of medications on urinary symptoms and flow rate: a community-based study.

The relationship between urinary symptoms and medication use was investigated in a community-based cross-sectional study involving a random sample of 2115 men 40-79 years of age in Olmsted County, Minnesota. The American Urological Association Symptom Index (AUASI) was generated from a validated self-administered questionnaire. Medication use was assessed by in-person interviews. While 1087 men reported daily medication use, only 136 reported daily use of medications known to affect urinary function adversely, including antidepressants (42), antihistamines (23), and bronchodilators (43). Age-adjusted AUASI scores were higher in men reporting daily use of antidepressants, and the association persisted after additionally adjusting for the Depression and Anxiety subscales of the General Psychological Well-Being Scale (adjusted mean difference, 2.1; 95% confidence interval (CI), 0.5-3.6; p = 0.008). The adjusted AUASI was also higher among men who took antihistamines daily (adjusted mean difference, 2.3; 95% CI, 0.3-4.3; p = 0.03). Lower age-adjusted urinary flow rates occurred with antidepressants, but not with antihistamines or bronchodilators. Clinicians evaluating men for causes of voiding dysfunction in accordance with the Agency for Health Care Policy and Research practice guideline for the diagnosis and management of benign prostatic hyperplasia should be aware that daily use of antidepressants or antihistamines may be associated with AUASI scores that are two to three points higher than in men not taking these medications.

Adult↗
PubMed1996

Natural history of prostatism: longitudinal changes in voiding symptoms in community dwelling men.

PURPOSE: We report the results of 3 contacts during 42 months of The Olmsted County Study of Urinary Symptoms and Health Status Among Men, a longitudinal cohort study of men 40 to 79 years old that was initiated in 1990 to describe changes in lower urinary tract symptom severity. MATERIALS AND METHODS: At baseline and followup, men completed questionnaires that elicited urinary symptom severity with questions nearly identical to those of the American Urological Association symptom index: RESULTS: Overall, there was an average increase in American Urological Association symptom index of approximately 0.18 (95% confidence interval 0.13 to 0.24) points per year of followup. The average annual symptom score slope and variability in slope increased with patient age at baseline from a mean of 0.05 +/- 1.06 (standard deviation) per year among men in the forties to 0.44 +/- 1.35 per year for men in the sixties, and decreased to 0.14 +/- 1.42 per year for men in the seventies. The age-related changes in symptom severity mirror previous estimates of prostatic growth from autopsy prevalence studies. CONCLUSIONS: These results demonstrate a slow but measurable progression in urinary symptom severity among community dwelling men for 42 months of followup.

Adult↗
PubMed1996

International comparison of the community prevalence of symptoms of prostatism in four countries.

We conducted an international comparison of the prevalence of urinary symptoms of prostatism in 4 countries, using a community-based random sampling of subjects, similar study procedures, and a single definition of cases that was based on a standardized symptom questionnaire. In Scotland 1,994 medically eligible men aged 40-79 years agreed to participate from 3 communities of the Forth Valley. In France, a nation-wide survey was conducted cross-sectionally in a representative sample of 2,011 French men aged 50-84 years. In the USA, the Olmsted County (OC) study recruited an age- and urban/rural-stratified random sample of 2,115 county residents drawn from medically eligible men aged 40-79 years. In Japan, 290 men aged 40-79 years from a fishing village participated in the study. Response rates were 55, 53, 55, and 43% in Scotland, France, OC and Japan, respectively. Urinary symptoms were assessed by the International Prostate Symptom Score (I-PSS), after metrologic validation in English and cross-cultural adaptation of the questionnaire. The prevalence of moderate to severe symptoms (I-PSS > 7) were 14, 18, 38, and 56% in France, Scotland, OC and Japan, respectively. This pattern was consistent within decades of age, and was found for most of the individual urinary symptoms. The proportion of men in Japan reporting very low I-PSS (0 or 1) was approximately 2, 4 and 8 times less frequent, than in OC, Scotland, and France, respectively. Differences in the prevalence of reported urinary symptoms might reflect between-country differences in the true prevalence of benign prostatic hyperplasia. However, cross-cultural differences in the perception and/or willingness to report urinary symptoms may play an important role in the observed differences. Further study will be required to elucidate the underlying causes of the observed differences.

Adult↗
PubMed1996

The effect of finasteride on prostate specific antigen: review of available data.

PURPOSE: We reviewed the available data on the effect of finasteride on serum levels of prostate specific antigen (PSA), PSA velocity and PSA density in men with benign prostatic hyperplasia (BPH) and prostate cancer. MATERIALS AND METHODS: To our knowledge all previously published analyses of PSA data from clinical trials of finasteride therapy for BPH and prostate cancer are reviewed. RESULTS: The normal reference range of serum PSA levels in men with BPH and no evidence of prostate cancer who were treated with finasteride for 6 months or longer is half that in untreated men with BPH. The percent by which serum levels of PSA are suppressed after 6 months of treatment for prostate cancer does not tend to be greater than that for BPH. CONCLUSIONS: To interpret serum PSA levels in men with BPH treated with finasteride for 6 months or longer, the serum PSA level should be multiplied by 2 and compared to either age-independent or age-specific upper limits of normal for serum PSA in untreated men with BPH. On the basis of limited data the sensitivity and specificity of this approach appear to be similar to those of the corresponding PSA limits in untreated men with BPH.

5-alpha Reductase Inhibitors↗
PubMed1996

Japanese men have smaller prostate volumes but comparable urinary flow rates relative to American men: results of community based studies in 2 countries.

PURPOSE: We compared prostate volume and peak urinary flow rate in Japanese and American men 40 to 79 years old. MATERIALS AND METHODS: Prostate volume and peak urinary flow rate were measured in eligible Japanese men and results were compared to those of a randomly selected American cohort. RESULTS: Mean prostate volume plus or minus standard deviation averaged 20.3 +/- 10.6 ml. in Japanese and 29.6 +/- 13.4 ml. in American men, while predicted cross-sectional increases with age decade were 1.5 and 5.5 ml., respectively. Peak urinary flow rate was higher but the decrease with increasing age was greater in Japanese men. CONCLUSIONS: Prostate volume is larger and the increase with age is more pronounced in American than in Japanese men. However, Japanese men may have a higher peak urinary flow rate and greater cross-sectional decrease with age.

Adult↗
PubMed1995

Recall accuracy for prescription medications: self-report compared with database information.

A methodological study was performed in 1992 to evaluate the accuracy of self-reported use of nonsteroidal antiinflammatory drugs (NSAIDs) and noncontraceptive estrogens that had been dispensed during the previous 12 years. A sample of 560 individuals dispensed NSAIDs or estrogens, and 140 individuals without NSAID/estrogen dispensations were selected from the Group Health Cooperative pharmacy database. Demographic, behavioral, and drug information was ascertained by telephone interview for 356 persons with and 98 persons without NSAID/estrogen dispensations. Of those with only a single NSAID dispensation, 41% (95% confidence interval (CI) 32-50%) were able to recall any NSAID use compared with 85% (95% CI 76-94%) for those with multiple NSAID dispensations. Thirty percent (95% CI 24-36%) recalled the NSAID name, and 15% (95% CI 10-20%) recalled both the name and dose. For estrogens, 78% (95% CI 70-86%) recalled the name, but only 26% (95% CI 17-34%) recalled the name and dose. Age, but not sex, appeared to influence recall accuracy: Persons 50-65 years of age recalled the NSAID name more accurately than those aged 66-80 (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.0-3.4). A similar advantage was noted for 50- to 65-year-old women in recalling the estrogen name (OR = 1.5, 95% CI 0.6-3.9). Drug name was recalled more frequently for exposures stopped 2-3 years prior to interview than for those stopped 7-11 years prior (OR = 3.0, 95% CI 1.6-5.7, and OR = 2.4, 95% CI 0.9-6.7, for NSAIDs and estrogens, respectively). Specificity was consistently high, ranging from 92% to 100%. This study suggests significant underascertainment of self-reported prescription drug exposure but little evidence that exposures are overreported.

Aged↗
PubMed1995

Association between family history of benign prostatic hyperplasia and urinary symptoms: results of a population-based study.

Baseline measurements for a population-based prospective cohort study were used to assess the association between family history of enlarged prostate and urinary symptoms. Between December 1989 and March 1991, a group of randomly selected men aged 40-79 years from Olmsted County, Minnesota, was administered a previously validated questionnaire that included questions with wording close to that of the American Urological Association's Symptom Index. A detailed family history of an enlarged prostate was obtained by personal interview, and peak urinary flow rates were measured for each participant. Of the 2,119 men, 440 (21 percent) reported a family history of an enlarged prostate. The age-adjusted odds of having moderate or severe urinary symptoms were elevated among those with a family history relative to those without (odds ratio = 1.3, 95 percent confidence interval 1.1-1.7). With simultaneous control for effects of age and worry about urologic function, the odds ratio remained at 1.3 (95 percent confidence interval 1.0-1.6). Furthermore, this risk was greater for men with relatives diagnosed at a younger age (odds ratio = 2.5, 95 percent confidence interval 1.5-4.3). Men with a family history were also 1.3 times as likely to have an impaired peak urinary flow rate. These findings suggest that men with a family history of an enlarged prostate may be at increased risk for development of symptoms and signs suggestive of benign prostatic hyperplasia and that this risk is greater in men with relatives diagnosed at a younger age. Recognition of this association may help to target early interventions and may lead to further clues about the causes of benign prostatic hyperplasia.

Adult↗