The progression of benign prostatic hyperplasia: Examining the evidence and determining the risk

Background: Benign prostatic hyperplasia (BPH) is often associated with enl argement of the prostate gland, lower urinary tract symptoms, decreased uri nary flow and a reduced quality of life. Furthermore, if the symptoms assoc iated with BPH are left untreated, serious complications, such as acute uri nary retention, may ensue. Evidence is emerging from long-term clinical stu dies to suggest that BPH is a progressive disease, with some patients progr essing much more rapidly than others. Objective: This article aims to explore the natural history of BPH progress ion from a molecular, pathological and clinical perspective, with emphasis on the key clinical evidence to support the progressive nature of this dise ase. How our increased understanding of the disease and of the risk factors for BPH progression might be applied to improve current management practic es are also discussed. Conclusion: Strategies to identify patients most at risk and guidelines dir ected towards longterm management, in addition to short-term treatment, may be useful in helping to prevent BPH progression. Copyright (C) 2007 S. Kar ger AG. Basel.