Abstract
Background: Natural history of voiding parameters with age is poorly understood. We aim to understand both subjective and objective lower urinary tract parameters in older men over 5 years.
Methods: The Concord Health and Ageing in Men Project is a prospective cohort study of older men, involving 1705 men aged 70 years and over living in Sydney, Australia. Men were assessed at 0, 2 and 5 years. Demographic information, medical history, International Prostate Symptom Score (IPSS), flow rate and post-void volume were collected at three timepoints.
Results: A total of 1705 men aged 70-97 years participated. At 2 and 5 year follow-up, 1367 and 940 men presented for assessment. Mean IPSS was 7.35 at baseline, 6.96 at 2 years (P = .9) and 7.18 at 5 years (P = .30). Mean flow rate at baseline was 15.0 ml/s, 14.6 ml/s at 2 years (P = .001) and 15.3 ml/s at 5 years (P = .42). Adjusting for age at baseline, the change in flow over 5 years was not significant (P = .93). Mean post-void residual was 72.4 ml at baseline, 84.0 ml at 2 years (P = .003) and 93.2 ml at 5 years (P = .001). Men with residual volume >200 ml at baseline had no significant change in residual over 5 years (P = .51).
Conclusions: Urinary symptoms and voiding parameters remain stable over 5 years. Men with elevated post-void volume did not deteriorate significantly. Conservative management of lower urinary tract symptoms appears a reasonable strategy in older men.