A community based study of prostatic symptoms in Singapore

Purpose: We describe the prevalence of prostatic symptoms, bother and related quality of life, as well as health seeking behavior in men 40 years old or older in Singapore. Materials and Methods: A community based cross-sectional study was conducted in men 40 years old or older in Queenstown, Singapore. The International Prostate Symptom Score for benign prostatic hyperplasia was used to score symptom severity objectively. Results obtained were compared to those from United States, Scottish and Japanese populations. Results: The prevalence of moderate to severe symptomatology was 10% after age adjustment to match the 1990 Singapore population. The most prevalent symptoms were frequency (22.5% of cases) and nocturia (21.5%) with consistently lower prevalence for bother (6.9% for frequency and nocturia). The prevalence of prostatic symptoms was approximately 3 or more times less than in the Scottish, United States and Japanese populations, while the prevalence of bother was approximately 10 times less. For symptomatic individuals there was poor correlation between symptom severity and bother scores. Bother scores correlated better with quality of life scores (r = 0.50) and were more closely associated with health seeking behavior (p = 0.03) than symptom severity scores (r = 0.39, p = 0.07). Conclusions: The prevalence of prostatic symptoms, severity and bothersomeness were all relatively low in Singapore. Bother was not analogous to symptom severity and should be considered independently in clinical decision making.