http://repub.eur.nl/res/aut/47550/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/33556/ 2011-01-01T00:00:00Z Purpose Although functional bladder capacity, as expressed by maximum voided volume and other frequency-volume chart parameters, are important determinants of lower urinary tract symptoms, to our knowledge no population based data are available on changes in voided volume. We determined changes in and determinants of voided volume and voiding frequency with advancing age and with time, as measured by frequency-volume charts. Materials and Methods We performed a longitudinal, population based study in 1,688 men 50 to 78 years old with followup at 2.1, 4.2 and 6.5 years. Data were obtained using frequency-volume charts for maximum, 24-hour and average voided volume, and 24-hour voiding frequency as well as physical and urological measurements, and self-administered questionnaires. We used a linear mixed effect model to determine factors predicting volume changes. Results Median maximum and average voided volume decreased with time from 400 to 380 and 245 to 240 ml, respectively, and were smaller in older age groups while 24-hour voided volume showed no change. The 24-hour voiding frequency increased with time and with advancing age. Maximum, 24-hour and average voided volumes were positively related to alcohol intake. Maximum and average voided volumes were negatively related to higher age at baseline and the passage of time. Hypertension, diuretics and post-void residual volume were related to higher 24-hour voided volume. Conclusions In older men maximum and average voided volume show a small but statistically significant decrease with time and with advancing age while 24-hour voided volume does not. Factors predicting the change in maximum or average voided volume are alcohol intake and higher age. http://repub.eur.nl/res/pub/32779/ 2010-07-26T00:00:00Z http://repub.eur.nl/res/pub/31831/ 2003-01-09T00:00:00Z http://repub.eur.nl/res/pub/31984/ 2002-10-09T00:00:00Z Although symptoms of the lower urogenital tract are common and bothersome in older men,H it seems that only a small percentage of men visit their general practitioner for these symptoms.4•5 With the ageing of the population, the number of men consulting their physician will increase significantly, with a related demand on health care resources. There are various guidelines for the evaluation and treatment of such symptoms,6•8 but these all suffer from a common drawback: in the evaluation of lower urogenital tract symptoms physicians are still hampered by a lack of consensus on definitions and normal values, by a lack of insight into their natural history and, consequently, by the lack of unambiguous diagnostic and therapeutic tools. This thesis addresses some of these problems by applying basic epidemiologic research methods to the following topics. The main research questions addressed in this work are: 1. What is the prevalence of LUTS in the Dutch community? 2. What is the prevalence and incidence of clinical benign prostatic hyperplasia, according to different definitions? 3. What are the normal values for the various components of lower urinary tract function, such as nocturnal and diurnal voiding frequency, urine production patterns, nocturnal urine production, average and functional bladder capacity, 24-hour voided volumes, prostate size, uroflowmetry and post void residual urine volumes? 4. What are appropriate definitions of abnormality for these parameters, especially in relation to LUTS or other conditions? 5. What is the natural history of LUTS, clinical benign prostatic hyperplasia and other urogenital tract parameters? 6. What is the prevalence and incidence of erectile and ejaculatory dysfunction? 7. What are the main determinants of these conditions? 8. What is the relation between LUTS and erectile and ejaculatory dysfunction? 9. What is the prevalence of sexual activity in relation to erectile and ejaculatory dysfunction? 10. How do LUTS and erectile and ejaculatory dysfunction relate to health status, separately and in conjunction with other medical conditions and sociodemographic factors? To address these questions, the Krimpen Study on male urogenital tract dysfunction and general wellbeing is being conducted. http://repub.eur.nl/res/pub/31837/ 2002-06-01T00:00:00Z Objective: To study health status and its correlates in older men with and without lower urogenital tract dysfunction. Methods: Cross-sectional population-based study on 1688 men aged 50-78 years without bladder or prostate cancer, radical prostatectomy, neurogenic bladder dysfunction or a negative advice from their general practitioner. Data were collected through self-administered questionnaires, including Sickness Impact Profile (SIP, three domains), Inventory of Subjective Health (ISH), International Prostate Symptom Score (IPSS) and International Continence Society (ICS) Male Sex questionnaire, medication use, socio-economic and lifestyle factors. Additional information was collected by measurement of blood pressure, transrectal ultrasonography of the prostate and uroflowmetry. Four health status domains were analyzed using the ISH and three domains of the SIP. Lower urinary tract symptoms (LUTS) were categorised using IPSS, erectile and ejaculatory dysfunction were defined using the ICS questionnaire. Results: All urogenital characteristics and parameters were related to at least two of the health status domains. Multivariate regression analyses yielded that LUTS and cardiac symptoms were associated with suboptimal scores of all four domains. Chronic obstructive pulmonary disease and drugs for abdominal symptoms were related to three domains; erectile and ejaculatory dysfunction, muskuloskeletal or psycho(ana)leptic drugs and marital status to two domains. Conclusions: The impact of LUTS on health status was equally important as the impact of cardiac symptoms. The impact of sexual dysfunction was smaller than expected. Longitudinal studies are needed to determine how health status and illnesses interact.