Levent Ozdal, MD, Research Fellow, Department of Urology, McGill University, Montreal, QC.
Simon Tanguay, MD, FRCS(C), Associate Professor, Department of Urology, McGill University, Montreal, QC.
Benign prostate hyperplasia (BPH) is the most common benign neoplasm in aging men. Although microscopic evidence of BPH occurs in 80% of men who are at least 80 years old, clinical enlargement of the gland only occurs in half of all men in this age group. Furthermore, symptomatic disease only develops in about half of men with clinically enlarged prostate glands.1
Lower urinary tract symptoms (LUTS) of BPH can be obstructive or irritative in nature. Most symptoms occur and progress slowly in aging men. The treatment of BPH is usually indicated once patients develop either moderate or severe symptoms, or in the presence of complications due to bladder obstruction. Complications of BPH due to chronic obstruction include recurrent urinary tract infection, bladder stones, incontinence, gross hematuria, urinary retention or renal failure.
The aim of BPH treatment should include improving or eradicating symptoms, reversing the complications of the disease and preventing additional sequelae. Treatment is typically based on the severity of symptoms and patient preference.