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Elizabeth A. Platz, ScD, MPH; Ichiro Kawachi, MD, PhD; Eric B. Rimm, ScD; Graham A. Colditz, MD, DrPH; Meir J. Stampfer, MD, DrPH; Walter C. Willett, MD, DrPH; Edward Giovannucci, MD, ScD

Arch Intern Med. 1998;158:2349-2356.

Background  Benign prostatic hyperplasia (BPH) leading to prostatic enlargement and lower urinary tract symptoms is highly prevalent among older men. Sympathetic nervous system activity, which is decreased by physical activity, is associated with increased prostatic smooth-muscle tone and prostatic symptoms. Therefore, we assessed whether physical activity leads to fewer lower urinary tract symptoms in the Health Professionals Follow-up Study.

Methods  We observed men who were aged 40 to 75 years at baseline in 1986 for subsequent incidence of surgery for BPH. The men were free of diagnosed cancer, including prostate cancer at baseline and during follow-up, had not had a radical prostatectomy, and provided data on physical activity. Cases were men who underwent BPH surgery between 1986 and 1994 (n=1890) or, among those who did not have surgery, who scored 15 or more points of 35 (n=1853) on 7 questions about lower urinary tract symptoms modified from the American Urological Association Symptom Index. Noncases were men who scored 7 points or less (n=21745). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from multiple logistic regression models.

Results  After controlling for age, race or ethnicity, alcohol consumption, and smoking, physical activity was inversely related with total BPH (extreme quintiles: OR, 0.75; 95% CI, 0.67-0.85; P for trend, <.001), surgery for BPH (OR, 0.76; 95% CI, 0.64-0.90; P for trend, <.001), and symptomatic BPH (OR, 0.75; 95% CI, 0.64-0.87; P for trend, <.001). Walking, the most prevalent activity, was inversely related to BPH risk; men who walked 2 to 3 h/wk had a 25% lower risk of total BPH.

Conclusion  Our results indicate that more physically active men have a lower frequency of lower urinary tract symptoms.

From the Departments of Epidemiology (Drs Platz, Rimm, Colditz, Stampfer, and Willett), Nutrition (Drs Platz, Rimm, Stampfer, Willett, and Giovannucci), and Health and Social Behavior (Dr Kawachi), Harvard School of Public Health, Boston, Mass; and Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston (Drs Kawachi, Rimm, Colditz, Stampfer, Willett, and Giovannucci).

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