Introduction: Benign prostatic hyperplasia (BPH) and its associated lower urinary tract symptoms (LUTS), including nocturia, are extremely common among middle- and older-aged American men. While studies of physical activity (PA) and prevalent BPH-related outcomes suggest that PA may protect against the development of this common condition, only a few studies have examined the relation between PA and incident BPH-related outcomes and LUTS with mixed findings. Additionally, although nocturia is the most commonly reported and most bothersome LUTS in men with or without evidence of BPH, few studies have examined the association of PA and nocturia independent of BPH. The purpose of this analysis was to examine the association of PA with BPH-related outcomes and nocturia in the PLCO Trial.
Methods: We examined this association with both prevalent (n=28,404) and incident (n=4,710) BPH-related outcomes (measured by self-report of physician diagnosis, BPH surgery, finasteride use and clinical indicators) and nocturia. Poisson regression with a robust variance was used to calculate prevalence ratios (PRs) and relative risks (RRs).
Results: PA was weakly positively associated with several prevalent BPH-related outcomes and was strongly inversely associated with prevalent nocturia. In incident analyses, PA was only associated with nocturia. Men who were active one or more hours/week were 13% less likely (95% CI: 2, 22%) to report nocturia and 34% less likely (95% CI: 15, 49%) to report severe nocturia as compared to men who reported no PA. The associations were similar for men with and without additional BPH-related outcomes, except for prevalent nocturia, where the association was stronger for men without other BPH-related outcomes.
Conclusions: Combined with other management strategies, PA may provide a strategy for the management of BPH-related outcomes, particularly nocturia.
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