Prevalence and factors associated with lower urinary tract symptoms suggestive of benign prostatic hyperplasia among men aged 50 years and above in Coimbatore district, Tamil Nadu, India: a community-based cross-sectional study

Objectives To estimate the prevalence of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) and to identify associated sociodemographic, lifestyle and comorbidity-related factors among men aged ≥50 years in a community setting. Design Community-based cross-sectional study. Setting Primary care and community settings in a district of southern India using multistage cluster sampling across urban and rural areas. Participants A total of 560 men aged ≥50 years were enrolled and completed the study. Participants were selected through multistage cluster sampling. Men with known alternative causes of LUTS (such as urinary tract infection, neurological disorders or prior prostate surgery) were excluded. Primary and secondary outcome measures The primary outcome was the prevalence of LUTS, suggestive of BPH, defined as an International Prostate Symptom Score (IPSS) ≥8. Secondary outcomes included the distribution of individual urinary symptoms, IPSS severity categories, quality-of-life scores and factors associated with LUTS. Outcomes were analysed using survey-weighted methods accounting for clustering and sampling weights. Results The survey-weighted mean (SD) IPSS score was 3.46 (2.64), with a median (IQR) of 3 (2-4). Most participants reported minimal urinary symptoms, including no incomplete emptying (82.1%), no urgency (81.4%), normal urinary stream (90.5%), and no straining (90.0%). Nocturia was common, with 43.6% waking once and 28.8% waking twice per night. Overall, 80.2% were mildly symptomatic, 10.1% moderately symptomatic and 0.4% severely symptomatic. The prevalence of LUTS suggestive of BPH was 10.32% (n=58; 95% CI 5.7 to 18.0). In survey-weighted multivariable Poisson regression, below-poverty-line status (adjusted prevalence ratio (APR) 4.13; 95% CI 1.38 to 12.41), physical inactivity (APR 2.89; 95% CI 1.81 to 4.63), diabetes mellitus (APR 2.58; 95% CI 1.26 to 5.30), cardiac disease (APR 3.27; 95% CI 1.67 to 6.41), and arthritis (APR 1.88; 95% CI 1.03 to 3.42) were independently associated with LUTS. Conclusions Approximately one in ten men aged ≥50 years had LUTS, suggestive of BPH. The findings indicate a higher prevalence of LUTS among men with socioeconomic disadvantage, physical inactivity and cardiometabolic comorbidities. Integrating symptom-based screening for LUTS into routine primary care and chronic disease follow-up may facilitate early identification and improve quality of life among older men. Further research is warranted to explore longitudinal relationships and alternative symptom thresholds in community populations.