A statistical study of the American Urological Association symptom index for benign prostatic hyperplasia in participants of mass screening program for prostatic diseases using transrectal sonography

Purpose: A study was done on the prevalence of urinary symptoms in community based populations in Japan regarding the influences of aging and benign prostatic hyperplasia (BPH) as evaluated by transrectal sonography. Materials and Methods: In 961 Japanese men 55 to 87 years old who underwent mass screening for prostatic diseases the American Urological Association symptom index scores were compared with age and ultrasonic diagnosis of the prostate. Results: Moderate to severe symptoms (symptom score 8 or more) were found in 265 of our 961 samples (27.6%), while BPH was also recognized ultrasonically in 197 (20.5%). Frequencies of urinary symptoms and BPH increased significantly with age. BPH related increase in total symptom scores occurred only in select men when adjusted by age. Conclusions: The ability of the American Urological Association symptom index to characterize BPH in an individual was limited because of the lack of specificity to the disease along with the considerable influence of aging on the symptom score. Currently, transrectal sonography is the most reliable method for the definitive diagnosis of BPH.