NATURAL HISTORY OF PROSTATISM--THE OLMSTED COUNTY STUDY

奥姆斯特德县尿路症状与健康状况研究 在男性中是一项关于泌尿系统老化的前瞻性队列研究，随机抽样 2000多名居住在社区的男子。这项研究取得了许多有意义的成果 对我们理解体征和症状的自然历史的贡献 与良性前列腺增生症(BPH)相关的无偏见的 出现在临床系列患者中。然而，这些发现仅限于 由默克研究实验室资助的最初十年的跟踪调查。自.以来 前列腺增生症是一种慢性进展性疾病，并发症明显。 在较长时期内，这一队列的持续后续行动是必要的，以积累 有足够的事件来提供长期风险信息。这些数据不是 目前是可用的，但对于做出知情的临床决定是必要的。 此外，延长跟踪将提高估计的精确度 BPH替代措施的变化，提供了更好的洞察 在没有临床试验的情况下有望在社区居住的男性中使用 布景。持续的跟踪也将使我们更好地了解 血清PSA水平如何随时间变化。本申请的具体目的是 旨在用额外的四年时间来扩展我们之前的发现 使用我们完善的方案进行后续行动。我们将确定 14年来临床(症状)、生理(最大尿流率)的进展 前列腺增生症的解剖学(前列腺体积)替代措施(目标1)。我们 我将研究这些如何随时间一起变化(目标2)并收集信息 关于并发症和治疗的长期风险，并将其与 前列腺增生症的替代措施(目标3)。我们还将评估纵向变化 血清PSA水平(目标4)，以增加我们对 前列腺癌患者血清PSA水平升高与前列腺生长的关系 癌症的威胁。因此，随着这些目标的实现，我们将提供 迫切需要深入了解前列腺增生症替代措施在理解中的作用 这一状况在整个社区的自然历史。这 信息将被证明对未来临床试验的设计和 流行病学研究。此外，我们将提供的信息是 为BPH的治疗做出明智的临床决策所必需的。

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.