Benign prostatic hyperplasia and lower urinary tract symptoms in men – aetiology, pathophysiology and epidemiology
Authors:
M. Záleský; R. Zachoval
Authors‘ workplace:
Urologické oddělení
; Primář: Doc. MUDr. Roman Zachoval, Ph. D.
; Thomayerova nemocnice, Praha
Published in:
Prakt. Lék. 2014; 94(5): 217-222
Category:
Reviews
Overview
Objective:
The aim of this article is to summarize information regarding the aetiology, pathophysiology and epidemiology of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) in men.
Methods:
References relating to the keywords benign prostatic hyperplasia AND (OR aetiology pathophysiology OR epidemiology) were searched using PubMed database. Information from these sources formed the basis of this article.
Results:
Currently used definitions of BPH and lower urinary tract symptoms are mentioned in this review. The theory of genesis of BPH and a cascade of events leading to the lower urinary tract symptoms in men with BPH are described. The facts about the natural history of benign prostatic hyperplasia and risk factors of progression of BPH also are mentioned. Subsequently prevalence of BPH and LUTS in men regarding definitions used in epidemiological studies is interpreted.
Conclusion:
The aetiology and pathophysiology of BPH and their relationship to LUTS are not yet fully understood. Benign prostatic hyperplasia is a progressive disease. According to the occurrence of the risk factors BPH may lead to worsening of symptoms of lower urinary tract or urinary retention unless therapy of BPH is used. Prevalence of LUTS in men as well as benign prostatic enlargement or BPH increases with age of men.
Keywords:
benign prostatic hyperplasia – lower urinary tract symptoms – aetiology – pathophysiology – epidemiology
Sources
1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002; 21(2): 167–178.
2. Andriole GL, Guess HA, Epstein JI, et al. Treatment with finasteride preserves usefulness of prostate-specific antigen in the detection of prostate cancer: results of a randomized, double-blind, placebo-controlled clinical trial. PLESS Study Group. Proscar Long-term Efficacy and Safety Study. Urology 1998; 52(2): 195–201; discussion 201–202.
3. Bautista OM, Kusek JW, Nyberg LM, et al. Study design of the medical therapy of prostatic symptoms (MTOPS) trial. Control Clin Trials 2003; 24(2): 224–243.
4. Benaim EA, Montoya JD, Saboorian MH, et al. Characterization of prostate size, PSA and endocrine profiles in patients with spinal cord injuries. Prostate Cancer Prostatic Dis 1998; 1(5): 250–255.
5. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol 1984; 132(3): 474–479.
6. Bosch JL, Hop WC, Kirkels WJ, Schroder FH. The international prostate symptom score in a community-based sample of men between 55 and 74 years of age: prevalence and correlation of symptoms with age, prostate volume, flow rate and residual urine volume. Br J Urol 1995; 75(5): 622–630.
7. Garraway, W. M, Collins, G. N, Lee, R. J. High prevalence of benign prostatic hypertrophy in the community. Lancet 1991; 338(8765): 469–471.
8. Geller J. Overview of benign prostatic hypertrophy. Urology 1989; 34(4 Suppl): 57–63, discussion 87–96.
9. Geller J, Albert J, de la Vega D, et al. Dihydrotestosterone concentration in prostate cancer tissue as a predictor of tumor differentiation and hormonal dependency. Cancer Res 1978; 38(11 Pt 2): 4349–4352.
10. Homma Y, Araki I, Igawa Y, et al. Clinical guideline for male lower urinary tract symptoms. Int J Urol 2009; 16(10): 775–790.
11. Chute CG, Panser LA, Girman CJ, et al. The prevalence of prostatism: a population-based survey of urinary symptoms. J Urol 1993; 150(1): 85–89.
12. Irwin DE, Milsom I, Kopp Z, et al. Prevalence, severity, and symptom bother of lower urinary tract symptoms among men in the EPIC study: impact of overactive bladder. Eur Urol 2009; 56(1): 14–20.
13. Isaacs JT, Coffey DS. Etiology and disease process of benign prostatic hyperplasia. Prostate Suppl 1989; 2: 33–50.
14. Jacobsen SJ, Guess HA, Panser L, et al. A population-based study of health care-seeking behavior for treatment of urinary symptoms. The Olmsted County Study of Urinary Symptoms and Health Status Among Men. Arch Fam Med 1993; 2(7): 729–735.
15. Jacobsen SJ, Jacobson DJ, Girman CJ, et al. Natural history of prostatism: risk factors for acute urinary retention. J Urol 1997; 158(2): 481–487.
16. Jacobsen SJ, Jacobson DJ, Girman CJ, et al. Treatment for benign prostatic hyperplasia among community dwelling men: the Olmsted County study of urinary symptoms and health status. J Urol 1999; 162(4): 1301–1306.
17. Jakobsen H, Torp-Pedersen S, Juul N. Ultrasonic evaluation of age-related human prostatic growth and development of benign prostatic hyperplasia. Scand J Urol Nephrol Suppl 1988; 107: 26–31.
18. Kolman C, Girman CJ, Jacobsen SJ, Lieber MM. Distribution of post-void residual urine volume in randomly selected men. J Urol 1999; 161(1): 122–127.
19. Kyprianou N, Tu H, Jacobs SC. Apoptotic versus proliferative activities in human benign prostatic hyperplasia. Hum Pathol 1996; 27(7): 668–675.
20. Lepor H. Pathophysiology, epidemiology, and natural history of benign prostatic hyperplasia. Rev Urol 2004; 6(Suppl 9): S3–S10.
21. McConnell JD, Bruskewitz R, Walsh P, et al. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group. N Engl J Med 1998; 338(9): 557–563.
22. McConnell JD, Roehrborn CG, Bautista OM, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med 2003; 349(25): 2387–2398.
23. McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol 2011; 185(5): 1793–1803.
24. Oelke M, Bachmann A, Descazeaud A, et al. EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 2013; 64(1): 118–140.
25. Oesterling JE, Jacobsen SJ, Chute CG, et al. Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA 1993; 270(7): 860–864.
26. Overland GB, Vatten L, Rhodes T, et al. Lower urinary tract symptoms, prostate volume and uroflow in norwegian community men. Eur Urol 2001; 39(1): 36–41.
27. Prins GS, Korach KS. The role of estrogens and estrogen receptors in normal prostate growth and disease. Steroids 2008; 73(3): 233–244.
28. Rhodes T, Girman CJ, Jacobsen SJ, et al. Longitudinal prostate growth rates during 5 years in randomly selected community men 40 to 79 years old. J Urol 1999; 161(4): 1174–1179.
29. Roberts RO, Jacobsen SJ, Jacobson DJ, et al. Longitudinal changes in peak urinary flow rates in a community based cohort. J Urol 2000; 163(1): 107–113.
30. Roehrborn C, Fuh V, Ruane P. The relationship between total and free PSA, prostate volume and age in men age 40–60 with no clinical diagnosis of benign prostatic hyperplasia necessitating therapy. J Urol (Suppl) 2000; 163: 252A.
31. Roehrborn CG. Definition of at-risk patients: baseline variables. BJU Int 2006; 97(Suppl 2): 7–11, discussion 21–22.
32. Roehrborn CG, Malice M, Cook TJ, Girman CJ. Clinical predictors of spontaneous acute urinary retention in men with LUTS and clinical BPH: a comprehensive analysis of the pooled placebo groups of several large clinical trials. Urology 2001; 58(2): 210–216.
33. Roehrborn CG, McConnell JD. Etiology, pathophysiology, epidemiology and natural history of benign prostatic hyperplasia. In: Walsh PC, Retik AB, Vaughan EDJ, Wein AJ. (eds). Campbell’s Urology. 8th ed. Philadelphia: WB Saunders Co 2002; 1297–1336.
34. Roehrborn CG, McConnell JD, Lieber M, et al. Serum prostate-specific antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. PLESS Study Group. Urology 1999; 53(3): 473–480.
35. Sarma AV, Jacobsen SJ, Girman CJ, et al. Concomitant longitudinal changes in frequency of and bother from lower urinary tract symptoms in community dwelling men. J Urol 2002; 168(4 Pt 1): 1446–1452.
36. Slawin KM, Kattan MW. The use of nomograms for selecting BPH candidates for dutasteride therapy. Rev Urol 2004; 6(Suppl 9): S40–S45.
37. Tsukamoto T, Kumamoto Y, Masumori N, et al. Prevalence of prostatism in Japanese men in a community-based study with comparison to a similar American study. J Urol 1995; 154(2 Pt 1): 391–395.
38. Walsh PC, Hutchins GM, Ewing LL. Tissue content of dihydrotestosterone in human prostatic hyperplasis is not supranormal. J Clin Invest 1983; 72(5): 1772–1777.
39. Walsh PC, Madden JD, Harrod MJ, et al. Familial incomplete male pseudohermaphroditism, type 2. Decreased dihydrotestosterone formation in pseudovaginal perineoscrotal hypospadias. N Engl J Med 1974; 291(18): 944–949.
Labels
Addictology Allergology and clinical immunology Anaesthesiology, Resuscitation and Inten Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric dermatology & STDs Paediatric gastroenterology Paediatric gynaecology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric clinical oncology Paediatric ENT Paediatric pneumology Paediatric psychiatry Paediatric radiology Paediatric urologist Diabetology Endocrinology Pharmacy Clinical pharmacology Physiotherapist, university degree Gastroenterology and hepatology Medical genetics Geriatrics Gynaecology and obstetrics Haematology Hygiene and epidemiology Hyperbaric medicine Vascular surgery Chest surgery Plastic surgery Medical virology Intensive Care Medicine Cardiac surgery Clinical speech therapy Clinical microbiology Nephrology Neonatology Neurosurgery Neurology Nuclear medicine Nutritive therapist Obesitology Ophthalmology Orthodontics Orthopaedics ENT (Otorhinolaryngology) Anatomical pathology Paediatrics Pneumology and ftiseology Burns medicine Occupational medicine General practitioner for children and adolescents General practitioner for adults Orthopaedic prosthetics Clinical psychology Radiodiagnostics Radiotherapy Rehabilitation Reproduction medicine Nurse Sexuology Forensic medical examiner Dental medicine Sports medicine Toxicology Trauma surgery Urology Laboratory Home nurse Phoniatrics Health Care Dental Hygienist Medical studentArticle was published in
General Practitioner
2014 Issue 5
Most read in this issue
- Epidemiology and diagnostics of larval toxocarosis
- Conditions for recognizing carpal tunnel syndrome from overuse as an occupational disease
- Benign prostatic hyperplasia and lower urinary tract symptoms in men – aetiology, pathophysiology and epidemiology
- Care ethics in the practice of general practitioner