Objective To study the lifetime occurrence of prostatitis in Finnish men and their exposure to the disease. Subjects and methods A population-based cross-sectional survey was conducted in the two most northerly provinces of Finland (Oulu and Lapland). Altogether, 2500 male residents aged 20±59 years were chosen at random to complete a questionnaire on prostatitis. The data were collected between June 1996 and October 1997. Replies were received from 1832 men, giving a response rate of 75%. Results The overall lifetime prevalence of prostatitis was 14.2%. The risk of having or having had prostatitis increased with age, being 1.7 times greater in men aged 40±49 years than in those aged 20±39 years, and 3.1 times greater in those aged 50±59 years. The overall incidence was 37.8/10 000 person years. More than a quarter of the 261 men who had or had had prostatitis symptoms (27%) suffered from them at least once a year, while 16% suffered from persistent symptoms; 63% of the men with prostatitis had their worst symptoms during the winter (November-March). Neither education nor profession had much in¯uence on the occurrence of prostatitis, but divorced and single men had a lower risk than married men. Most patients felt they had not received enough information about the disease at their ®rst visit to a general practitioner. Conclusions The results of this survey showed that the occurrence of prostatitis symptoms in men living in northern Finland is higher than that reported in other parts of the world. This could be partly caused by the cold climate.

Objective To determine the occurrence of mental distress related to prostatitis in Finnish men. Subjects and methods A population-based cross-sectional survey was conducted of 2500 men aged 20±59 years living in the two northernmost provinces of Finland (Oulu and Lapland). The ®nal response rate was 75% (1832 men). Results The fear of undetected prostate cancer was reported by 17% of the men in the population who had had prostatitis, a value signi®cantly higher (P<0.001) than in healthy men. Fears of having a sexually transmitted disease and suicidal thinking were also slightly more common. The men who had had prostatitis preferred to be alone in a public toilet during voiding (58% vs 44%, P<0.001). Erectile dysfunction was reported by 43% of the men with symptomatic prostatitis and decreased libido by 24%. Self-assessment of personality, adjusted for age, showed that the men with prostatitis were more often busy and nervous than the healthy controls (P<0.001), and that they had a more meticulous attitude to life and its problems. Marital dif®culties were reported by 17% of the men who had had prostatitis at some point in their lives, and 4% were convinced that their illness had caused their divorce. Socio-economic status and social well-being had no apparent in¯uence on the occurrence of prostatitis. Conclusions This survey showed that psychological stress is common in men with prostatitis. Urologists and general practitioners should consider that a consultation with a psychiatrist may be appropriate for selected men with prostatitis.

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BackgroundThis study was performed to evaluate the impact of baseline characteristics and treatment methods on the outcome of sporadic renal angiomyolipoma (AML).MethodsThis was a pooled analysis of individual data of 441 patients with AML retrieved from 58 studies and 3 institutional series.ResultsNinety-three patients underwent nephrectomy, 163 partial nephrectomy/enucleation, 128 embolisation, 19 cryoablation, 6 radiofrequency ablation, and 32 conservative treatment. Their mean follow-up period was 44.5 months. Patients who experienced major bleeding at presentation had significantly larger tumours than did those without bleeding (mean diameter, 10.1 vs. 5.9 cm, respectively; p < 0.0001). A total of 9.4 % and 26.4 % of bleeding tumours had a diameter of <4 and <6 cm, respectively. A tumour diameter of ≥8.0 cm (hazard ratio, 2.07; 95 % confidence interval, 1.20–4.77) and the treatment method (p = 0.001) were independent predictors of re-intervention. The risk of re-intervention was significantly higher after embolisation, particularly for large tumours (5-year rate of freedom from re-intervention: diameter of ≥8.0 cm, 49.2 %; diameter of <8.0 cm, 74.8 %; p = 0.018). Conservatively treated AMLs had a mean baseline diameter of 3.2 ± 2.7 cm; after 41 months, their mean diameter was 3.7 ± 3.1 cm (p = 0.109).ConclusionsThe prevalence of major bleeding is high in sporadic AMLs with a diameter of >6 cm. These results suggest that conservative treatment can be considered in AMLs of <6 cm in diameter. Among current treatment methods, embolisation was associated with a significantly higher risk of re-intervention. Further studies are needed to define risk factors for bleeding and assess the relative benefits of different treatment modalities.