Widely Varying Estimates of BPH in South Korea Leads to Call for Better Study Approaches

Widely Varying Estimates of BPH in South Korea Leads to Call for Better Study Approaches

An epidemiological study by researchers in South Korea shows that most aspects of lower urinary tract symptoms (LUTS) are as common there as in other previously examined populations.

But the study, “Overview of the Epidemiology of Lower Urinary Tract Dysfunction in South Korea,” published in the journal International Neurology Journal, concluded that study methods need to be improved to reduce the huge variations found in estimates of  prostate enlargement and urinary tract symptoms among groups of people.

While several large epidemiological studies have explored the degree of lower urinary tract symptoms and benign prostatic hyperplasia found in Western countries, South Korea has only recently started to gather epidemiological data on these symptoms. (Epidemiological studies analyze patterns in health and disease in distinct populations.)

LUTS can come in many shapes and forms, and include conditions where it is difficult to urinate or urination is overly frequent, or where patients are plagued with incontinence. Difficulty in urinating is most often caused by benign prostatic hyperplasia (BPH), which is also linked to other symptoms, such as the need to urinate during the night, feelings of urgency, or the inability to empty the bladder.

Earlier studies have shown that between 40 and 70 percent of men between the ages of 60 and 70 are affected by prostate enlargement. Because of a lack of consensus on how to define clinical BPH, it is a difficult to study how widespread the condition is in a population. Estimates naturally vary depending on how the disease is defined.

Examining previously published studies, researchers with Korea University College of Medicine found that reports stated that between 11 and 40 percent of men in South Korea had BPH. The large differences seemed to be caused by the use of varying methods, the age of the population, and the diagnostic criteria used.

Although studies came to rather varying conclusions, the numbers mirror findings from studies in Western and Eastern countries. Earlier studies also suggested that Asians often have more severe symptoms of prostate enlargement than men of European origin, but it is difficult to conclude if this finding is tied to biology or merely reflects differences in study design.

Researchers also examined how widespread LUTS is, without linking it to prostate enlargement. One study found that in men ages 50-59, LUTS was present among 23.3 percent. This number increased with age, and participants age 70 or older had rates of about 35 percent. Another study found a similar age-related increase in urinary tract symptoms, but found that 45 percent of men age 70 or older had LUTS.

Even higher numbers have been reported, with one study finding rates of more than 80 percent in a sample of nearly 2,000 men in South Korea older than 40. Again, the numbers were similar to what has been reported in the West. “More studies on the optimal approaches to epidemiologic study will be needed in the future. These should include technical improvements in methodologies,” the researchers concluded.

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Magdalena is a writer with a passion for bridging the gap between the people performing research, and those who want or need to understand it. She writes about medical science and drug discovery. She holds an MS in Pharmaceutical Bioscience and a PhD — spanning the fields of psychiatry, immunology, and neuropharmacology — from Karolinska Institutet in Sweden.

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