NATURAL HISTORY OF PROSTATISM--THE OLMSTED COUNTY STUDY

奥姆斯特德县泌尿系统症状和健康状况研究 是一项前瞻性队列研究，在男性中随机抽样， 超过2,000名社区居民这项研究提出了一些重要的 对我们理解体征和症状的自然史的贡献 与良性前列腺增生（BPH）相关， 在临床系列患者中存在。然而，这些发现仅限于 最初的十年随访由默克研究实验室资助。以来 BPH是一种慢性、进行性疾病， 长期以来，该队列的持续随访是必要的， 足够的事件提供长期风险信息。这些数据不是 目前可用，但必须作出明智的临床决策。 此外，扩大后续行动将提高估计的准确性， BPH替代指标的变化，更好地了解 在没有临床试验的情况下， 设置.持续的后续行动还将使人们更好地了解 血清PSA水平如何随时间变化本申请的具体目的 旨在扩展我们先前的发现， 我们已经建立了完善的协议康贝特人将以 14-临床（症状）、生理（峰值尿流） 率）和BPH的解剖学（前列腺体积）替代指标（目标1）。我们 我将研究这些因素如何随时间变化（目标2），并收集信息 关于并发症和治疗的长期风险， BPH的替代指标（目标3）。我们还将评估纵向变化 血清PSA水平（目的4），以增加我们对 PSA水平升高与无前列腺增生症患者前列腺生长之间的关系 癌症。因此，随着这些目标的完成，我们将提供 对BPH替代指标在了解BPH中的作用的迫切需要的洞察力 这种情况在整个社区的自然历史。这 这些信息将被证明对未来临床试验的设计有用， 流行病学研究。此外，我们将提供信息， 为BPH的治疗做出明智的临床决策是必要的。

The Olmsted County Study of Urinary Symptoms and Health Status among Men is a prospective cohort study of urologic aging in a random sample of over 2,000 community-dwelling men. This study has made a number of significant contributions to our understanding of the natural history of signs and symptoms related to benign prostatic hyperplasia (BPH) that are free from the biases present in clinical series of patients. These findings, however, are limited to an initial ten years of follow-up that was funded by Merck Research Labs. Since BPH is a chronic, progressive disease and complications are manifest over extended periods, the continued follow-up of this cohort is necessary to accrue sufficient events to provide long-term risk information. These data are not presently available but are necessary to make informed clinical decisions. Furthermore, extending follow-up will increase the precision of estimates of change in surrogate measures of BPH, providing better insight into what would be expected in community-dwelling men in the absence of a clinical trial setting. The continued follow-up also will provide a better understanding of how serum PSA levels change over time. The specific aims for this application are designed to expand upon our previous findings with an additional four years of follow-up using our well-established protocols. We will determine the 14-year progression of clinical (symptoms), physiologic (peak urinary flow rates) and anatomic (prostate volume) surrogate measures of BPH (Aim 1). We will examine how these vary together over time (Aim 2) and gather information on long-term risk of complications and treatment and relate this to the surrogate measures of BPH (Aim 3). We will also assess the longitudinal changes in serum PSA levels (Aim 4) in order to increase our understanding of the relationship between increases in PSA levels and prostate growth in the absence of cancer. Thus, with the completion of these aims, we will have provided much-needed insight into the role of surrogate measures of BPH in understanding the natural history of this condition in the community at large. This information will prove useful in the design of future clinical trials and epidemiologic studies. Furthermore, we will have provided information that is necessary for informed clinical decision making for treatment of BPH.