Quality of life with pharmacological treatment in patients with benign prostatic enlargement: results from the Evolution European Prospective Multicenter Multi-National Registry Study

Research output: Contribution to journalArticle


Background: Lower urinary tract symptoms due to benign prostate enlargement (LUTS/BPE) can lead to significant disturbances to health-related quality of life (HRQoL) and psychological well-being. The aim of this study was to evaluate the effect of pharmacological treatment of LUTS/BPE on disease specific and generic QOL measures. Methods: Evolution was a European prospective, multicenter multi-national, observational registry collecting real-life clinical data over 2 years on the management of LUTS/BPE in primary and secondary care. This study investigated disease-specific QOL using questionnaires such as IPSS Q8, BPH Impact Index (BII) and generic QOL using questionnaires like EuroQOL Five Dimension (EQ5D) which encompassed EQ5D VAS and EQ5D health index. Results: The registry enrolled 1838 BPE patients and 1246 patients were evaluable at the end of 24 months. Nearly 70% of patients in the study were previously treated with medical therapy and 17% of these had already discontinued medical treatment previously for various reasons with lack of efficacy being the most common. The mean time since diagnosis of LUTS in the previously treated group was 4.7 years (0–26 years). Medical management produced statistically significant improvement in QOL (disease specific and generic) in previously untreated patients and an insignificant change in generic QOL in previously treated patients. Conclusions: After 5-years from the onset of symptoms, LUTS/BPE patients previously treated with medication had significantly impaired QOL in patients in a manner comparable to other chronic diseases. Earlier intervention with minimally invasive surgical techniques (MIT) should be considered in LUTS/BPE patients that do not show a significant improvement in QOL with medical therapy.


  • Nikita R. Bhatt
  • Niall F. Davis
  • W. P. Witjes
  • A. Bjartell
  • C. Caris
  • A. Patel
  • A. de la Taille
  • A. Tubaro
External organisations
  • Royal College of Surgeons in Ireland
  • European Association of Urology, Research Foundation
  • Spire London East Hospital
  • Sapienza University of Rome
  • Ipswich Hospital NHS Trust
  • Beaumont Hospital, Dublin
  • Henri Mondor Hospital
  • Sant'Andrea Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Urology and Nephrology


  • IPSS, Lower urinary tract symptoms, Medical treatment, Registry
Original languageEnglish
JournalWorld Journal of Urology
Publication statusE-pub ahead of print - 2020 May 4
Publication categoryResearch