Abstract
Clinicians treat the symptoms associated with BPH on a daily basis. Although BPH is nearly universal with age, not all men develop lower urinary tract symptoms. Over the past 100 years, several notable advances in the field of urology have not only improved our understanding of the aetiology and natural history of this common disease, but have also facilitated the development of therapeutics to effectively manage BPH-related symptoms. The high quality of modern-day diagnosis, as well as medical and surgical treatment for BPH, is a testimony to centuries of observation and decades of scientific research.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Groves, H. K., Chang, D., Palazzi, K., Cohen, S. & Parsons, J. K. The incidence of acute urinary retention secondary to BPH is increasing among California men. Prostate Cancer Prostatic Dis. 16, 260–265 (2013).
Walsh, P. C. Benign prostatic hyperplasia: etiological considerations. Prog. Clin. Biol. Res. 6, 1–8 (1976).
Steadman, F. H. & Krichesky, B. Prostate and seminal vesicle response to testosterone propionate in intact and castrate rats. Endocrinology 37, 89–95 (1945).
Siiteri, P. K. & Wilson, J. D. Dihydrotestosterone in prostatic hypertrophy. I. The formation and content of dihydrotestosterone in the hypertrophic prostate of man. J. Clin. Invest. 49, 1737–1745 (1970).
Horton, R., Hsieh, P., Barberia, J., Pages, L. & Cosgrove, M. Altered blood androgens in elderly men with prostate hyperplasia. J. Clin. Endocrinol. Metab. 41, 793–796 (1975).
Theyer, G. et al. Phenotypic characterization of infiltrating leukocytes in benign prostatic hyperplasia. Lab. Invest. 66, 96–107 (1992).
Story, M. T. et al. Cultured human prostate-derived fibroblasts produce a factor that stimulates their growth with properties indistinguishable from basic fibroblast growth factor. Prostate 15, 355–365 (1989).
Klein, L. A. & Stoff, J. S. Prostaglandins and the prostate: an hypothesis on the etiology of benign prostatic hyperplasia. Prostate 4, 247–251 (1983).
Kahokehr, A., Vather, R., Nixon, A. & Hill, A. G. Non-steroidal anti-inflammatory drugs for lower urinary tract symptoms in benign prostatic hyperplasia: systematic review and meta-analysis of randomized controlled trials. BJU Int. 111, 304–311 (2013).
Berry, S. J., Coffey, D. S., Walsh, P. C. & Ewing, L. L. The development of human benign prostatic hyperplasia with age. J. Urol. 132, 474–479 (1984).
Nielsen, K. K., Nordling, J. & Hald, T. Critical review of the diagnosis of prostatic obstruction. Neurourol. Urodyn. 13, 201–217 (1994).
Abrams, P. Managing lower urinary tract symptoms in older men. BMJ 310, 1113–1117 (1995).
Abrams, P. et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 61, 37–49 (2003).
Abrams, P. Objective evaluation of bladder outlet obstruction. Br. J. Urol. 76 (Suppl. 1), 11–15 (1995).
Abrams, P. H., Farrar, D. J., Turner-Warwick, R. T., Whiteside, C. G. & Feneley, R. C. The results of prostatectomy: a symptomatic and urodynamic analysis of 152 patients. J. Urol. 121, 640–642 (1979).
Abrams, P. H. & Griffiths, D. J. The assessment of prostatic obstruction from urodynamic measurements and from residual urine. Br. J. Urol. 51, 129–134 (1979).
Griffiths, D. et al. Standardization of terminology of lower urinary tract function: pressure-flow studies of voiding, urethral resistance, and urethral obstruction. International Continence Society Subcommittee on Standardization of Terminology of Pressure-Flow Studies. Neurourol. Urodyn. 16, 1–18 (1997).
Barry, M. J. et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J. Urol. 148, 1549–1557 (1992).
Haltbakk, J., Hanestad, B. R. & Hunskaar, S. How important are men's lower urinary tract symptoms (LUTS) and their impact on the quality of life (QOL)? Qual. Life Res. 14, 1733–1741 (2005).
McConnell, J. D. 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. 338, 557–563 (1998).
Bruskewitz, R. et al. Effect of finasteride on bother and other health-related quality of life aspects associated with benign prostatic hyperplasia. PLESS Study Group. Proscar Long-term Efficacy and Safety Study. Urology 54, 670–678 (1999).
Flanigan, R. C. et al. 5-year outcome of surgical resection and watchful waiting for men with moderately symptomatic benign prostatic hyperplasia: a Department of Veterans Affairs cooperative study. J. Urol. 160, 12–16 (1998).
McConnell, J. D. et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N. Engl. J. Med. 349, 2387–2398 (2003).
Lieber, M. M. et al. Natural history of benign prostatic enlargement: long-term longitudinal population-based study of prostate volume doubling times. BJU Int. 105, 214–219 (2010).
Caine, M., Perlberg, S. & Meretyk, S. A placebo-controlled double-blind study of the effect of phenoxybenzamine in benign prostatic obstruction. Br. J. Urol. 50, 551–554 (1978).
Lepor, H. et al. A randomized, placebo-controlled multicenter study of the efficacy and safety of terazosin in the treatment of benign prostatic hyperplasia. J. Urol. 148, 1467–1474 (1992).
Lukacs, B., Grange, J. C., Comet, D. & McCarthy, C. History of 7,093 patients with lower urinary tract symptoms related to benign prostatic hyperplasia treated with alfuzosin in general practice up to 3 years. Eur. Urol. 37, 183–190 (2000).
Gormley, G. J. et al. The effect of finasteride in men with benign prostatic hyperplasia. The Finasteride Study Group. N. Engl. J. Med. 327, 1185–1191 (1992).
Hudson, P. B. et al. Efficacy of finasteride is maintained in patients with benign prostatic hyperplasia treated for 5 years. The North American Finasteride Study Group. Urology 53, 690–695 (1999).
Lepor, H. et al. The efficacy of terazosin, finasteride, or both in benign prostatic hyperplasia. Veterans Affairs Cooperative Studies Benign Prostatic Hyperplasia Study Group. N. Engl. J. Med. 335, 533–539 (1996).
Kirby, R. S. et al. Efficacy and tolerability of doxazosin and finasteride, alone or in combination, in treatment of symptomatic benign prostatic hyperplasia: the Prospective European Doxazosin and Combination Therapy (PREDICT) trial. Urology 61, 119–126 (2003).
Roehrborn, C. G. et al. The effects of dutasteride, tamsulosin and combination therapy on lower urinary tract symptoms in men with benign prostatic hyperplasia and prostatic enlargement: 2-year results from the CombAT study. J. Urol. 179, 616–621 (2008).
Sairam, K., Kulinskaya, E., McNicholas, T. A., Boustead, G. B. & Hanbury, D. C. Sildenafil influences lower urinary tract symptoms. BJU Int. 90, 836–839 (2002).
McVary, K. T. et al. Sildenafil citrate improves erectile function and urinary symptoms in men with erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia: a randomized, double-blind trial. J. Urol. 177, 1071–1077 (2007).
Andersson, K. E. et al. Tadalafil for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: pathophysiology and mechanism(s) of action. Neurourol. Urodyn. 30, 292–301 (2011).
Giuliano, F. et al. The mechanism of action of phosphodiesterase type 5 inhibitors in the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia. Eur. Urol. 63, 506–516 (2013).
Novara, G., Galfano, A., Ficarra, V. & Artibani, W. Anticholinergic drugs in patients with bladder outlet obstruction and lower urinary tract symptoms: a systematic review. Eur. Urol. 50, 675–683 (2006).
Filson, C. P., Hollingsworth, J. M., Clemens, J. Q. & Wei, J. T. The efficacy and safety of combined therapy with alpha-blockers and anticholinergics for men with benign prostatic hyperplasia: a meta-analysis. J. Urol. 190, 2153–2160 (2013).
Weissbart, S. J. et al. Acetylcholine for male LUTS. Curr. Urol. Rep. 13, 413–419 (2012).
Blandy, J. P., Notley, R. G. & Reynard, J. M. Transurethral resection, 5th edn (Taylor & Francis, 2005).
Bottini, E. Die galvanocaustische Diaerese zur Radical-Behandlung der Ischurie bei Hypertrophie der Prostata [German]. Arch. Klin. Chir. 54, 96 (1896).
McGill, A. F. Suprapubic prostatectomy. BMJ 2, 1104 (1887).
Wilson, H. H. Asepsis in prostatectomy. Br. J. Surg. 33, 41–46 (1945).
Beer, E. Removal of neoplasms of the urinary bladder. A new method employing high frequency (Oudin) currents through a catheterising cystoscope. JAMA 45, 1768 (1910).
Bugbee, H. G. The relief of vesical obstruction in selected cases: preliminary report. NY State Med. J. 13, 410 (1913).
Luys, G. T. Raitement de l'hypertrophie de la prostate par la voie endourétrale [French]. Clinique 44, 693 (1913).
Stern, M. Resections of obstructions at the vesical orifice. JAMA 87, 1726–1730 (1926).
Iglesias, J. J. & Stams, U. K. How to prevent the TUR syndrome [German]. Urologe 14, 287–291 (1975).
Botto, H. et al. Electrovaporization of the prostate with the Gyrus device. J. Endourol. 15, 313–316 (2001).
Omar, M. I. et al. Systematic review and meta-analysis of the clinical effectiveness of bipolar compared with monopolar transurethral resection of the prostate (TURP). BJU Int. 113, 24–35 (2014).
Kaplan, S. A. & Te, A. E. Transurethral electrovaporization of the prostate: a novel method for treating men with benign prostatic hyperplasia. Urology 45, 566–572 (1995).
Schulman, C. C. et al. Transurethral needle ablation (TUNA): safety, feasibility, and tolerance of a new office procedure for treatment of benign prostatic hyperplasia. Eur. Urol. 24, 415–423 (1993).
Yerushalmi, A. et al. Localized deep microwave hyperthermia in the treatment of poor operative risk patients with benign prostatic hyperplasia. J. Urol. 133, 873–876 (1985).
Costello, A. J., Bowsher, W. G., Bolton, D. M., Braslis, K. G. & Burt, J. Laser ablation of the prostate in patients with benign prostatic hypertrophy. Br. J. Urol. 69, 603–608 (1992).
Kaplan, S. A. & Te, A. E. A comparative study of transurethral resection of the prostate using a modified electro-vaporizing loop and transurethral laser vaporization of the prostate. J. Urol. 154, 1785–1790 (1995).
Gilling, P. J., Cass, C. B., Malcolm, A. R. & Fraundorfer, M. R. Combination holmium and Nd:YAG laser ablation of the prostate: initial clinical experience. J. Endourol. 9, 151–153 (1995).
Gilling, P. J., Kennett, K., Das, A. K., Thompson, D. & Fraundorfer, M. R. Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J. Endourol. 12, 457–459 (1998).
Gilling, P. J. et al. Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int. 109, 408–411 (2012).
Kuntz, R. M., Lehrich, K. & Ahyai, S. A. Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur. Urol. 53, 160–166 (2008).
Naspro, R. et al. Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up. Eur. Urol. 50, 563–568 (2006).
Bouchier-Hayes, D. M., Anderson, P., Van Appledorn, S., Bugeja, P. & Costello, A. J. KTP laser versus transurethral resection: early results of a randomized trial. J. Endourol. 20, 580–585 (2006).
Maria, G. et al. Relief by botulinum toxin of voiding dysfunction due to benign prostatic hyperplasia: results of a randomized, placebo-controlled study. Urology 62, 259–264 (2003).
Denmeade, S. R. et al. Phase 1 and 2 studies demonstrate the safety and efficacy of intraprostatic injection of PRX302 for the targeted treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. Eur. Urol. 59, 747–754 (2011).
McNicholas, T. A. et al. Minimally invasive prostatic urethral lift: surgical technique and multinational experience. Eur. Urol. 64, 292–299 (2013).
Author information
Authors and Affiliations
Contributions
Both authors researched data for the article, contributed to the discussion of content and wrote the article. P. J. Gilling reviewed the manuscript before submission.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Kahokehr, A., Gilling, P. Landmarks in BPH—from aetiology to medical and surgical management. Nat Rev Urol 11, 118–122 (2014). https://doi.org/10.1038/nrurol.2013.318
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrurol.2013.318
This article is cited by
-
Combined top-down approach with low-power thulium laser enucleation of prostate: evaluation of one-year functional outcomes
World Journal of Urology (2021)
-
BPH: Why Do Patients Fail Medical Therapy?
Current Urology Reports (2019)
-
Prostatic artery embolization for benign prostatic obstruction: assessment of safety and efficacy
World Journal of Urology (2018)