• Risk factors for BPH:
  • No convincing evidence exists regarding a positive correlation for any factors other than age and the presence of testes
  • Smoking has been suggested to be negatively associated with prostatectomy,
  • BPH does appear to have an inheritable genetic component, although the specifics are yet to be elucidated
• Although LUTS due to BPH are generally progressive over time, spontaneous improvement can occur in an untreated patient, and thus the course may be highly variable.
• Over a 1- to 5-year period,
  • Approximately 18 to 32 percent of patients with clinical BPH will experience subjective improvement,
  • 15 to 52 percent will have no change
  • 16 to 60 percent will experience a worsening in their symptomatology.
• Although BPH is rarely life-threatening, it is generally considered to be a slowly progressive disease.

References

• Abrams P: In support of pressure-flow studies for evaluating men with lower urinary tract symptoms. Urology 44:153-155, 1994.
• Ball AJ, Fenely RCL, Abrams PH: The natural history of untreated "prostatism " Br J Urol 53:613-616, 1981.
• Barry MJ: Epidemiology of benign prostatic hyperplasia. AUA Update Series 16:274-279, 1997.
• Barry MJ, Fowler FJ, Bin L, et al: The natural history of patients with benign prostatic hyperplasia as diagnosed by North American urologists. J Urol 157:10-15, 1997.
• Barry MJ, Fowler FJ, Jr., O'Leary MP, and the Measurement Committee of the AUA: The American Urological Association symptom index for benign prostatic hyperplasia. J Urol 148:1549-1557, 1992.
• Barry MJ, Williford WO, Chang Y, et al: Benign prostatic hyperplasia specific health status measures in clinical research: How much change in the AUA symptom index and the BPH impact index is perceptible to patients? J Urol 154:1770-1774, 1995.
• Blaivas J: The bladder is an unreliable witness. Neurourol Urodyn 15:443-445, 1996.
• Denis L, Griffiths K, Khoury S, et al, eds. 4th International Consultation on Benign Prostatic Hyperplasia (BPH). Plymouth, United Kingdom, Plymbridge Distributors, Ltd., 1998.

  Chapter 3: Regulation of prostatic growth. Cockett ATK, Coffey D, DiSant Agnese A, et al.
  Chapter 5: Initial evaluation of LUTS. Artibani W, Correa R, Desgranchamps F, et al.
  Chapter 6: Quantification of symptoms, quality of life and sexuality. Adolfsson J, Barry M, Batista JE, et al.
  Chapter 7: The urodynamics of LUTS. Abrams P, Buzelin JM, Griffiths D, et al.
  Chapter 10: Interventional therapy. Altwein J, Baba S, Blute M, et al. Chapter 11: Endocrine treatment. Akaza H, Bartsch G, Calais daSilva F, et al. Chapter 12: Alpha-blocker therapy. AldoBono V, Andersson KE, Chapple C, et al.
  Chapter 15: BPH 1997-New treatment strategy. ElHilali M, Kirby R, McConnell J.
  Lepor H, Williford WO, Barry MJ, et al: The efficacy of terazosin, finasteride, or both in BPH. N Engl J Med 335:533-539, 1996.

• McConnell J: Why pressure flow studies should be optional and not mandatory for evaluating men with benign prostatic hyperplasia. Urology 44:156-158, 1994.
• McConnell JD, Barry MJ, Bruskewitz R, et al: Benign prostatic hyperplasia: Diagnosis and treatment. Clinical Practice Guideline, no. 8, AHCPR publication No. 94-0582, Rockville, Md., Agency for Health Care Policy Research, Public Health Service, US Dept. Of Health and Human Services, 1994.
• Walsh PC, Retik AB, Vaughan ED Jr., Wein AJ, eds: Campbell's Urology, 7th ed. Philadelphia, Saunders Company, 1998. Chapter 45: The molecular biology, endocrinology, and physiology of the prostate and seminal vesicles. Partin AW, Coffey DS.

  Chapter 46: Epidemiology, etiology, pathophysiology, and diagnosis of benign prostatic hyperplasia. McConnell JD.
  Chapter 47: Natural history, evaluation, and nonsurgical management of benign prostatic hyperplasia. Lepor H.
  Chapter 48: Minimally invasive treatment of benign prostatic hyperplasia. McCullough DL.
  Chapter 49: Transurethral surgery. Mebust WK.

• Wasson JH, Reda DJ, Bruskewitz RC, et al: A comparison of transurethral surgery with watchful waiting for moderate symptoms of BPH. N Engl J Med 332:75-79,1995.
• Wein AJ: Criteria for assessing outcome following intervention for benign prostatic hyperplasia. In: Lepor H, ed. Prostatic Diseases. Philadelpha, Saunders, 1999, pp 210-231.

Please log-in or register in order to submit comments.

Powered by AkoComment!