Association of online health information exposure with disease awareness initial symptom severity in benign prostatic hyperplasia: a cross-sectional study

Xiaoxiao Guo^1,2,#, Mingyu Chang^1,2,#, Gangyue Hao^1,2, Fengbo Zhang^3,*, Haoran Xia^1,2,*
1 Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
2 Institute of Urology, Beijing Municipal Health Commission, Beijing, China
3 Department of Urology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
* Corresponding Author: Fengbo Zhang. Email: email ; Haoran Xia. Email: email
# Xiaoxiao Guo and Mingyu Chang contribute equally to this work.

Canadian Journal of Urology https://doi.org/10.32604/cju.2026.075599

Received 04 November 2025; Accepted 27 January 2026; Published online 24 February 2026

Abstract

Background: Benign prostatic hyperplasia (BPH) is prevalent among aging men. Whether exposure to internet-derived health information is associated with disease awareness and symptom burden at initial diagnosis remains unclear. Methods: We conducted a cross-sectional study of 400 newly diagnosed BPH outpatients. Participants were classified by prior exposure to internet-derived BPH content. BPH awareness and International Prostate Symptom Scores (IPSS) were compared using the Mann-Whitney U test and multivariate linear regression adjusted for age, education, and disposable income. Stratified analyses were performed according to educational attainment, disposable income, and content format. Results: Exposure to internet-derived BPH content was independently associated with higher awareness and lower IPSS. Compared with unexposed participants, exposed participants had higher awareness (median 1.5 vs. 0) and lower IPSS (median 7.0 vs. 10.5) (both p < 0.001). In multivariable models, being unexposed was associated with a 1.39-point lower awareness score and a 2.20-point higher IPSS (both p < 0.001). In stratified analyses, the associations remained significant across education and income strata. Among exposed participants, those accessing text-based or mixed-format content had higher awareness and lower IPSS than those exposed to videos only (both p < 0.001). Conclusions: This study shows that exposure to internet-derived health content is significantly associated with higher BPH awareness and a lower symptom burden at initial presentation. Text-based or mixed-format content may be more effective than video-only formats.