Benign prostatic hyperplasia (BPH), which causes lower urinary tract symptoms (LUTS), is a common diagnosis among the ageing male population with increasing prevalence. Many risks factors, both modifiable and non-modifiable, can increase the risk of development and progression of BPH and LUTS. The symptoms can be obstructive (resulting in urinary hesitancy, weak stream, straining or prolonged voiding) or irritative (resulting in increased urinary frequency and urgency, nocturia, urge incontinence and reduced voiding volumes), or can affect the patient after micturition (for example, postvoid dribble or incomplete emptying). BPH occurs when both stromal and epithelial cells of the prostate in the transitional zone proliferate by processes that are thought to be influenced by inflammation and sex hormones, causing prostate enlargement. Patients with LUTS undergo several key diagnostic investigations before being diagnosed with BPH. Treatment options for men with BPH start at watchful waiting and progress through medical to surgical interventions. For the majority of patients, the starting point on the treatment pathway will be dictated by their symptoms and degree of bother.
Nature reviews. Disease primers. 2016 May 05*** epublish ***
Bilal Chughtai, James C Forde, Dominique Dana Marie Thomas, Leanna Laor, Tania Hossack, Henry H Woo, Alexis E Te, Steven A Kaplan
Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA., Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA., Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA., Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA., Department of Urology, Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, Australia., Department of Urology, Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, Australia., Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA., Department of Urology, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, 625 Madison Avenue, New York, New York 10022, USA.